We present a case of catamenial pneumothorax due to bilateral pulmonary endometriosis in a 45-year-old woman. [ncbi.nlm.nih.gov]

We present four cases of CP. Patient 1 is 31 years old and presented with chest pain, dyspnea and a right hemothorax. [elsevier.es]

We present a case in which a diaphragmatic interruption was clearly visualized during video-assisted thoracoscopy. [mayoclinic.pure.elsevier.com]

• Dyspnea

  Gradually, however, the pain occurred more frequently and became associated with dyspnea and a sensation of a "fluid motion" in her chest. [mayoclinic.pure.elsevier.com]

  Conclusion Catamenial Pneumothorax remains underdiagnosed but should be suspected in reproductive age women who present with cyclical dyspnea during the perimenstrual period. [onlinelibrary.wiley.com]

  Patient 1 is 31 years old and presented with chest pain, dyspnea and a right hemothorax. [elsevier.es]

  A 45-year-old nonsmoking woman with repeated coughing and dyspnea on effort was admitted to our hospital diagnosed with right-sided pneumothorax on chest X-ray. Chest computed tomography showed neither bullae nor nodules. [ncbi.nlm.nih.gov]

• Hyperresonance

  Physical examination was remarkable for decreased breath sounds and hyperresonance over the right hemithorax. Her labs were unremarkable. Chest radiography revealed a right pneumothorax ( Figure 1 ). [amjmed.org]

  Physical findings classically consist of absent tactile fremitus, hyperresonance to percussion, and decreased breath sounds on the affected side. [merckmanuals.com]

  Signs Examination may be unremarkable Tachycardia may be the only clinical finding (single most common finding) Keep high index of suspicion COPD patients Tall, thin males Changes on affected side Unilateral absent or decreased breath sounds Hyperresonance [fpnotebook.com]

• Pleuritic Pain

  The patient recalled often having developed the right-sided pleuritic pain of pneumothorax during or shortly after sexual intercourse. She had no symptoms or signs to suggest endometriosis. [ncbi.nlm.nih.gov]

• Deepening of Voice

  Hormonal control using danazol has its own risks and side effects such as hirsutism and deepening of voice, which are irreversible changes even when the drugs are stopped, and with GnRH analogs, complications such as postmenopausal symptoms and osteoporosis [nigjcardiol.org]

• Loss of Appetite

  The patient presented with a 3-year history of intermittent productive cough with blood-tinged sputum, chronic anemia, loss of appetite, and general weakness associated with menstruation. [ncbi.nlm.nih.gov]

• Increased Appetite

  The side effects of these drugs include abdominal swelling, breast tenderness, increased appetite, water retention, nausea, spotting and deep vein thrombosis (Berkow, 1997). [rtso.ca]

• Chest Pain

  Menstruation stopped, and the chest pain disappeared. During a 6-month follow-up period, pneumothorax did not recur. A 38-year-old female smoker reported having had intermittent, recurrent right-sided chest pain for several months. [nejm.org]

• Cervical Mucus Plug

  Air supposedly flows into the peritoneum via the fallopian tubes due to the absence of a cervical mucus plug during the menstrual cycle. [3,13-18] Retrograde menstruation (migration theory) The clockwise directionality of peritoneal flow from the right [cureus.com]

  In the menstrual period the cervical mucus plug is absent, thus permitting communication between the peritoneal cavity and the outside through the uterine and the fallopian tubes. [ijcasereportsandimages.com]

  mucus plug. 4, 6 This latter theory explains the non-endometriosis-related catamenial pneumothorax better. [rc.rcjournal.com]

  The air that enters the thorax is hypothesized to originate from the fallopian tubes due to a lack of cervical mucus plug during menstruation, then travels through the peritoneum and past the diaphragm. [biomedgrid.com]

  mucus plug, passage of air from the genital tract through congenital or acquired diaphragmatic defects. [scipedia.com]

During workup a comprehensive metabolic panel and a complete blood count were normal. An arterial blood gas showed mild acute respiratory alkalosis. An electrocardiogram showed normal sinus rhythm. Troponin levels were within normal limits. [casereports.in]

• Pneumothorax on Chest X-Ray

  A 45-year-old nonsmoking woman with repeated coughing and dyspnea on effort was admitted to our hospital diagnosed with right-sided pneumothorax on chest X-ray. Chest computed tomography showed neither bullae nor nodules. [ncbi.nlm.nih.gov]

The fourth patient suffered a postoperative recurrence when hormonal treatment was delayed for 6 weeks, stressing the importance of hormonal treatment in conjunction with surgery. [ncbi.nlm.nih.gov]

Table 1 Patient characteristics, treatment and outcome Patients Age Intraop. findings Treatment Chest tube Hormonal Recurrence Recurrence (days) treatment treatment 1 37 Diaphragm defect DR, AP, AR, CP 4 GnRH agonist No 2 36 Diaphragm defect DR, AP, AR [academic.oup.com]

MANAGEMENT AND TREATMENT A variety of treatments for catamenial pneumothorax have been tried over the years ranging from non-invasive hormonal treatment to the invasive diaphragmatic resection. [rtso.ca]

Treatment and prognosis Most catamenial pneumothoraces are small and self-resolving. Partial diaphragmatic resection and/or excision of visceral pleural implants, as well as talc pleurodesis, are sometimes carried out as part of treatment. [radiopaedia.org]

We want to emphasize how the importance of conducting a diagnosis and having a timely management would improve the quality of life of the patient and give a better prognosis of the disease. [clinicsinsurgery.com]

Prognosis As I mentioned above recurrence is more common if the surgeon fails to recognise the catamenial pattern and treat the cause of the CM PMX. [mactheknife.org]

The prognosis is usually favorable and depends on several factors such as age, time of compression and associated injuries. Contributors : ROJ: patient management, literature review, KVB: literature review, writing manuscript. [casereports.in]

Although it has been known to be associated with thoracic endometriosis, varying clinical course and the lack of consistent intraoperative findings have led to conflicting etiological theories. [ncbi.nlm.nih.gov]

The condition is now more easily recognized and several studies have been published, with somewhat relevant discrepancies with respect to etiologic, epidemiologic, and management features. [insights.ovid.com]

Epidemiology Some sources claim this entity represents 3-6% of pneumothorax in women. [ 8 ] In regard of the low incidence of primary spontaneous pneumothorax ( i.e. not due to surgical trauma etc. ) in women (about 1/100'000/year), [ 8 ] this is a very [thefullwiki.org]

Neurology and Neurosurgery Czech and Slovak Ophthalmology Czech and Slovak Psychiatry Czech Geriatric Review Czech Gynaecology Czech Rheumatology Czech Dental Journal Czech Urology Czech-Slovak Dermatology Czecho-Slovak Pathology Czech-Slovak Pediatrics Epidemiology [prolekare.cz]

To elucidate the pathophysiology of catamenial pneumothorax (CP) due to thoracic endometriosis and support the theory of the transdiaphragmatic passage of air from the genital tract through diaphragmatic perforations caused by endometrial implants. [ncbi.nlm.nih.gov]

[…] metastases esp. osteosarcoma, pancreas, adrenal, Wilms tumor (e) Connective tissue disorder: scleroderma, rheumatoid disease, Marfan syndrome, EhlersDanlos syndrome (f) Pneumoconiosis: silicosis, berylliosis (g) Vascular disease: pulmonary infarction Pathophysiology [slideshare.net]

Pathophysiology Endometrial tissue attaches within the thoracic cavity, forming chocolate-like cysts. [thefullwiki.org]

Although the exact pathophysiology of catamenial pneumothorax is still unknown, there are 3 main theories. [rc.rcjournal.com]

However, emphasizing secondary prevention, we developed a new method. This powerful new technique for prevention of pneumothorax during menstruation by surgical pleurodesis using absorbable mesh is presented. [ncbi.nlm.nih.gov]

The next step tends to be using a GnRH agonist or other forms of hormonal treatment to prevent recurrence. [rtso.ca]