Abstract
A 50-year-old woman known to have severe endometriosis was referred with cyclic pelvic pain, right shoulder pain, and recurring bilateral pleural effusions necessitating near-monthly thoracentesis of up to one liter of fluid. Gonadotrophin-releasing hormone agonism produced incomplete success. Diaphragmatic endometriosis is a condition affecting 1.5% of patients with endometriosis [1]. The mechanism postulated combines Sampson's theory of retrograde menstruation with clockwise transport of endometrial cells into the right subdiaphragmatic space via peritoneal fluid [1].
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