Diaphragmatic endometriosis is another form of extra pelvic endometriosis in which tissue that resembles the endometrial lining grows on the diaphragm. The diaphragm is a muscle that separates the chest from the abdomen and allows us to breathe. It is estimated that around 12% of patients with endometriosis have extra pelvic disease but the prevalence of diaphragmatic endometriosis is unknown.
If you have diaphragmatic endometriosis, you may be asymptomatic, but you may also experience the following symptoms:
- Chest pain
- Upper quadrant abdominal pain
- Cyclical Shoulder pain
- Pain on breathing
- Cyclical Shortness of breath
Diaphragmatic endometriosis can also present with a combination of symptoms termed Thoracic Endometriosis Syndrome (TES). These include pneumothorax (air in the thorax outside of the lungs), hemothorax (blood in the thoracic cavity), coughing blood or having endometriotic nodules within the thorax.
Diagnosis:
After collecting information on your symptoms, your doctor will examine both your pelvic and abdominal areas. They will order further imaging such as a pelvic and abdominal MRI.
Definitive diagnosis then happens through surgery. Laparoscopic visualization of the endometriotic lesions provides a diagnosis of diaphragmatic endometriosis.
Treatment:
Like pelvic endometriosis, medications may play a role in symptom control but surgical excision of the endometriotic lesions remains the optimal treatment.
Surgery used to be done through a big abdominal incision but laparoscopy and robotic-assisted approaches have been taking over and allow for a minimally invasive approach with quicker recovery and smaller incisions. Ask your doctor about the best surgery for you.
At CEAPS, we always opt for minimally invasive approaches to provide the best experience for our patients with the least amount of side effects and complications. Diaphragmatic surgery is technically challenging and requires sometimes a multidisciplinary approach with a thoracic surgeon.
Choose your surgeon with the training and the experience to manage these complex conditions.
Dr. Moawad is a highly reputable leading expert in this domain.
