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

Fertil Steril. 2008 Apr;89(4):991.e13-5. doi: 10.1016/j.fertnstert.2007.04.011. Epub 2007 Jul 2.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cysts / complications*
  • Cysts / etiology
  • Cysts / pathology
  • Cysts / surgery
  • Diagnosis, Differential
  • Electrosurgery*
  • Emergency Medical Services
  • Endometriosis / complications
  • Endometriosis / diagnosis*
  • Endometriosis / pathology
  • Endometriosis / surgery
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Recurrence
  • Rupture
  • Treatment Outcome
  • Uterine Cervical Diseases / complications
  • Uterine Cervical Diseases / diagnosis*
  • Uterine Cervical Diseases / pathology
  • Uterine Cervical Diseases / surgery
  • Uterine Hemorrhage / etiology
  • Uterine Hemorrhage / pathology
  • Uterine Hemorrhage / surgery*