Catamenial pneumothorax revealing diaphragmatic endometriosis: a case report and revue of literature

Abstract

Catamenial pneumothorax (CP) is a rare entity of spontaneous, recurring pneumothorax in women. We aim to discuss the etiology, clinical course, and surgical treatment of a 42-year-old woman with CP. This patient had a right-sided spontaneous pneumothoraces occurred one week after menses. She had under-gone video-assisted thoracoscopic surgery (VATS) because of a persistent air leak under chest tube. VATS revealed multiple diaphragmatic fenestrations with an upper right nodule. Defects were removed and a large part of the diaphragm was resected. Pleural abrasion was then performed over the diaphragm. Diaphragmatic endometriosis was confirmed by microscopic examination. Medical treatment with GnRH agonists was prescribed, and after recovery, the patient has been symptoms free for 20 months.

Left-sided Catamenial Pneumothorax: A Rare Clinical Entity

“…Thoracic endometriosis syndrome (TES) is characterized by the presence of endometrial tissue in or around the lung, and it consists of four distinct clinical presentations: catamenial pneumothorax (CP), catamenial hemothorax, hemoptysis, and pulmonary nodules [ 3 ]. CP consists of 30%-50% of all cases of thoracic endometriosis syndrome (TES) [ 1 ]. A diagnosis of CP requires a high degree of clinical suspicion relating pulmonary symptoms temporally to the phase of menstrual cycle.…”

“…The presence of endometrial tissue outside the uterine cavity is termed endometriosis while its presence inside the thoracic cavity is known as thoracic endometriosis [ 1 - 2 ]. Thoracic endometriosis syndrome includes four distinct clinical presentations: catamenial pneumothorax (CP), catamenial hemothorax, hemoptysis, and pulmonary nodules [ 3 ].…”

“…Thoracic endometriosis syndrome includes four distinct clinical presentations: catamenial pneumothorax (CP), catamenial hemothorax, hemoptysis, and pulmonary nodules [ 3 ]. CP is a rare form of spontaneous pneumothorax (PTX) that occurs predominantly in women of reproductive age, typically within 72 hours from the onset of menstrual bleeding [ 1 - 3 ]. In 1958, Maurer et al described the first case of recurrent PTX associated with concomitant menstruation [ 4 ].…”

Endometriosis: An Unusual Cause of Bilateral Pneumothoraces

“…Symptoms can be as simple as chest pain or as severe as the symptoms with which this patient presented. 1 The number of known episodes of catamenial pneumothorax prior to treatment average between two and eight. 2 We describe a rare presentation of catamenial pneumothorax given the bilateral presentation.…”

The Problem of Treatment of Endometriosis-Associated Pneumothrax: Difficult Diagnosis or Failes of Tactics?

“…В подавляющем большинстве случаев причиной пневмоторакса является буллезная эмфизема легких. Однако встречаются и другие причины, в частности, экстрагенитальный эндометриоз грудной клетки, который является проявлением системного эндометриоидного поражения [1,6].…”