Endometriosis Research Today is a free monthly online journal that collates and summarizes the latest research about Endometriosis, including details on causes, treatment, symptoms, infertility.

Successful management of a massive hemorrhage due to rupture of cystic cervical endometriosis by a loop electrosurgical excision procedure.

Iwase A, Goto M, Kurotsuchi S, Harata T, Kaseki S, Kikkawa F

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan. akiwase@med.nagoya-u.ac.jp

OBJECTIVE: To report a case of cystic cervical endometriosis that caused a massive hemorrhage due to rupture of a cyst and successful management with a loop electrosurgical excision procedure (LEEP). DESIGN: Case report. SETTING: University Hospital. PATIENT: A 37-year-old nulliparous woman. INTERVENTION(S): Medical management including surgical treatment. MAIN OUTCOME MEASURE(S): Clinical follow-up and pathologic diagnosis. RESULT(S): A hemorrhagic cystic cervical mass was excised with emergent LEEP. The mass was found to be cervical endometriosis. There was no evidence of recurrence until 1 year after excision. CONCLUSION(S): Cystic formation of cervical endometriosis--like ovarian endometrioma, which causes a massive hemorrhage due to rupture--is extremely rare, although cervical endometriosis is generally asymptomatic. Hysterectomy is considered in such cases but can be avoided via LEEP that incorporates partial excision of the uterine cervix.

Published 14 April 2008 in Fertil Steril, 89(4): 991.e13-5.
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