Thoracic endometriosis syndrome refers to the varying clinical and radiological manifestations associated with the growth of endometrial glands and stroma in the lungs or on the pleural surface. There are four clinical entities namely: catamenial pneumothorax, catamenial hemothorax, catamenial hemoptysis and lung nodules. Among the four catamenial pneumothorax is the most frequent presentation, accounting for approximately 80% cases. Catamenial pneumothorax is a recurrent pneumothorax occuring within 72 hours after the onset of menstruation but somewhat different time frames are possible. In this case report, a 41 year old nulligravid presented with recurrent difficulty of breathing, right sided chest pain and cough that coincided with her menstrual cycles. Chest x-ray and chest CT scan showed right pneumothorax. She underwent Video Assisted Thoracospic Surgery, talc and mechanical pleurodesis, chest tube thoracostomy, followed by continous combined oral contraceptive pills postoperatively. There was no recurrence of symptoms at 9 months follow-up.

Human ; Female ; Adult ; Catamenial Pneumothorax ; Pneumothorax ; Pleurodesis ; Hemothorax ; Menstruation ; Thoracostomy ; Chest Tubes ; Hemoptysis

Catamenial pneumothorax is defined as recurrent and spontaneous pneumothorax occurring within 48 to 72 hours of the onset of menstruation. The etiology is unknown but several theories have been proposed. This is the case of a 45- year- old G2P2 with an eight- year history of on and off chest pain and difficulty of breathing coinciding with menstruation that resolved spontaneously. On two occasions of intractable pulmonary distress during menstruation, diagnosed as spontaneous pneumothorax, thoracostomy, thoracotomy, and mechanical, and eventually, chemical pleurodesis were performed. With a clinical diagnosis of catamenial pneumothorax, continuous oral contraceptive pills were given while patient was being stabilized. When OCP's were discontinued 9 months after, the pulmonary symptoms promptly recurred. Total abdominal hysterectomy with bilateral salpingooophorectomy (THBSO) was finally performed. Patient has remained asymptomatic more than 2 years after surgery. The management of catamenial pneumothorax may be initiated based on clinical signs and symptoms in the face of possible catastrophic complications which in this case is spontaneous pneumothorax.

Human ; Female ; Middle Aged ; Catamenial Pneumothorax ; Pneumothorax ; Menstruation ; Thoracostomy ; Thoracotomy ; Pleurodesis ; Contraceptives, Oral, Combined ; Chest Pain ; Thorax ; Hysterectomy

Thoracic endometriosis syndrome refers to the varying clinical and radiological manifestations associated with the growth of endometrial glands and stroma in the lungs or on the pleural surface. There are four clinical entities namely: catamenial pneumothorax, catamenial hemothorax, catamenial hemoptysis and lung nodules. Among the four catamenial pneumothorax is the most frequent presentation, accounting for approximately 80% cases. Catamenial pneumothorax is a recurrent pneumothorax occuring within 72 hours after the onset of menstruation but somewhat different time frames are possible. In this case report, a 41 year old nulligravid presented with recurrent difficulty of breathing, right sided chest pain and cough that coincided with her menstrual cycles. Chest x-ray and chest CT scan showed right pneumothorax. She underwent Video Assisted Thoracospic Surgery, talc and mechanical pleurodesis, chest tube thoracostomy, followed by continous combined oral contraceptive pills postoperatively. There was no recurrence of symptoms at 9 months follow-up.
Human ; Female ; Adult ; PNEUMOTHORAX ; CATAMENIAL PNEUMOTHORAX