Catamenial pneumothorax is the medical term for a collapsed lung caused by air or gas in the space area around the lungs. The term “catamenial” means monthly and is commonly associated with menstrual periods. A case of recurrent catamenial pneumothoraces for two years and no treatment solutions in their home country, and two previous thoracic surgeries, was operated in our centre, in a multidisciplinary team.
What is thoracic endometriosis?
Thoracic endometriosis represents the presence of endometrial-like tissue in the lung parenchyma and/or the pleura. Considered a rare entity, thoracic endometriosis is the main cause of catamenial pneumothorax. Endometriosis is found most frequently in the pelvis, and when its in places outside the pelvis, its called extrapelvic endometriosis. Based on studies, the thoracic cavity is the most common site of endometriosis outside of the abdominopelvic.
Case report for catamenial pneumothorax
An international patient known with a history of monthly pneumothoraces contacted us for endometriosis surgery. Every period, the patient will visit the A&E pneumothorax and severe dyspnea.
The treatment that she was offered was: insertion of a thoracic tube and hospitalisation for 3-4 days until the pneumothorax would go away. This went on for more than 2 years. The patient also underwent two thoracic surgery prior to coming to our centre.
After having her records seen, surgery was booked, with our thoracic surgeon, Dr Konstantinos Konstandinis. For the pelvic endometriosis, excision was used. A pleurectomy and pleurodesis wwere aslo performed. After surgery, the patient no longer had episodes of catamenial pneumothorax.
What is catamenial pneumothoraxes?
Patients with catamenial pneumothorax have recurrent episodes of pneumothorax that occur within 72 hours before or after the start of their period. Pneumothorax represents accumulation of air or gas in the pleural space. The term refers to a condition in which air or gas is trapped in the space surrounding the lungs causing the lungs to collapse.
Catamenial pneumothorax is one the 4th forms of thoracic endometriosis syndrome. The other three are: catamenial hematothorax, catamenial hemoptysis, and endometrial lung nodules. It usually occurs on the right side, around 90% of cases,. This is because pleural lesions are most frequently found on the right side. However it can be found on the left side as well. Pneumothorax typically presents with chest pain, sometimes with dyspnoea.
Surgery for thoracic endometriosis and catamenial pneumothorax
Surgery for thoracic endometriosis is done in a multidisciplinary team, an endometriosis specialist and a thoracic surgeon. When endometriosis affects the thoracic cavity a VATS can be done.
