[Endometriosis of the diaphragm. Diagnostic aspects apropos of a case without pneumothorax]

Abstract

Diaphragmatic disease is a rare manifestation of endometriosis. In the literature it is most often revealed by catamenial pneumothorax. We describe the case of a 21-year old woman presenting with tight-sided phrenic neuralgia, lasting 18 months. Signs of pelvic endometriosis appearing later on, laparoscopy showing thin lesions of endometriosis on the diaphragmatic undersurface. We review the few similar cases described earlier. They confirm that imaging studies are of little value, the diagnosis being made only after the discovery of pelvis disease. Our study of the multiple causes of phrenic neuralgia allows to establish criteria indicating when laparoscopy is warranted. Increasing practice of this test will shed light on the natural history of diaphragmatic endometriosis.