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Severe recurrent ascites in a Pseudo-Meigs’ syndrome variant

Obstetrics & Gynecology International Journal
Ayser Al-Mshhdani MD, Claudia Payá Ten MD, Justin To MD, FACOG

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Background: Meigs’ syndrome is the triad of ovarian neoplasm, ascites and pleural effusion, while Pseudo-Meigs’ syndrome is the presence of ascites and pleural effusion with other pelvic tumors. Ascites resolves after tumor resection. Our case does not meet classic criteria for either but is likely a variant of Pseudo-Meigs’ syndrome.
Case: A 30-year-old female had multiple Emergency Department visits for abdominal pain, distention, and shortness of breath. Imaging showed severe abdominal ascites with a large leiomyomatous uterus but no pleural effusions. Multiple paracenteses revealed benign cytology. After counselling, she underwent an abdominal myomectomy which resolved her recurrent ascites.
Conclusion: Variants of Pseudo-Meigs’ syndrome should be considered in the differential of abdominal pain and leiomyomas with ascites, and surgical management should be offered.


Pseudo-Meigs’ syndrome, Pleural effusion, Abdominal pain, Electrocardiogram, Ovarian hyperstimulation syndrome