Video-assisted surgical diagnosis and pleural adhesion management in catamenial pneumothorax: A case and literature review

Respirol Case Rep. 2023 Mar 22;11(4):e01123. doi: 10.1002/rcr2.1123. eCollection 2023 Apr.

Abstract

Catamenial pneumothorax is a rare primary spontaneous pneumothorax associated with the menstrual phase and is the most common manifestation of thoracic endometriosis syndrome. We report a case of a 32-year-old woman with a history of endometriosis who presented to the emergency ward with a chief complaint of dyspnea and right-sided chest pain, and a chest X-ray showed a right pneumothorax. Initial management was by placing a chest tube to expand the right lung. The patient underwent a video-assisted thoracoscopy and talc pleurodesis, during which we found multiple perforations in the tendinous part of the diaphragm. A partial resection of the tendinous part of the diaphragm was done. Our review indicated that primary spontaneous pneumothorax in women should be suspected as catamenial pneumothorax due to thoracic endometriosis. The gold standard procedure for diagnosis and treatment is surgery. Hormonal therapy is an effective choice to prevent and reduce post-operative recurrence.

Keywords: catamenial pneumothorax; diaphragm abnormalities; endometriosis associated diseases; pleural diseases; video‐assisted thoracoscopic surgery.

Publication types

  • Case Reports