A Special Case Report of Aggressive Hemorrhage in Posterior Vaginal Fornix DIE

Abstract

Deep infiltrating endometriosis (DIE) is defined by the presence of endometrial implants, fibrosis, and muscular hyperplasia below the peritoneum, invading the tissue to a depth of more than 5 mm [1]. Deep endometriosis involves, in descending order of frequency, the uterosacral ligaments (USL), the rectosigmoid colon, the vagina, and the bladder [2]. Pain and infertility are the main manifestations of DIE, including dysmenorrhea pain, chronic pelvic pain, dyspareunia, defecation pain, dysuria and back pain. DIE lesions are deep infiltration, severe pain symptoms, poor conservative treatment, difficult surgery, pelvic adhesions, and high risk of surgical accessory injury. It has been a difficult point in clinical treatment of endometriosis and gynecological laparoscopic surgery, there is no unified clinical type and treatment specifications [3-4]. This paper reported a special case of recurrent vaginal hemorrhage caused by posterior vaginal fornix DIE.