Catamenial Pneumothorax
Abstract
Objectives To evaluate the incidence of catamenial pneumothorax (CP) among women who have been referred for the surgical treatment of spontaneous pneumothorax (SP) and to study its pathogenic mechanisms.Design A prospective study of women of reproductive age who have been referred to our center for the surgical treatment of SP. Patients with pneumothorax secondary to a known lung disease were excluded.Setting A university hospital.Methods At the preoperative evaluation, special attention was given to the investigation of a possible temporal relationship between pneumothorax and menses. Video-assisted thoracoscopy constituted the operative technique of choice. The lung was inspected to identify blebs or bullae and the origin of possible air leaks. Signs of thoracic endometriosis were also carefully searched for. The diaphragm was systematically inspected to search for holes and/or endometrial implants. When limited diaphragmatic abnormalities were found, a partial diaphragmatic resection was carried out using an endoscopic stapler. In case of lesions that were not accessible by a purely endoscopic approach, a utility minithoracotomy was used.Results In an 18-month period, 32 women with SP were referred for surgery. In eight cases, the catamenial character of the pneumothorax was recognized by clinical history. In all these patients, the following diaphragmatic abnormalities were found at surgery: holes (one patient); endometrial implants (three patients); and both (four patients). Visceral pleural endometriosis was found in one patient. During pathologic examination, diaphragmatic endometriosis was confirmed in seven of the eight cases. In one patient, it was associated with pulmonary and pleural endometriosis. In only one patient (with multiple diaphragmatic holes and a pulmonary nodular brown lesion), endometriosis could not be confirmed at histology, but signs of parenchymal focal hemorrhages were found.Conclusions Our experience shows that (1) CP is more frequent than expected and (2) diaphragmatic abnormalities seem to play a fundamental role in its pathogenesis.
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20%-35% of spontaneous pneumothorax in reproductive-aged women are reported to be CP.
“Regarding frequency, 20%‐35% of spontaneous pneumothorax in reproductive‐aged women are reported to be CP.”
From Extra-pelvic endometriosis: a review. (2020) · cites this paper as [73]
The coelomic metaplasia theory can explain plural endometriotic lesions but cannot explain the right-sided predominance.
“This theory can explain plural endometriotic lesions, but cannot explain the right‐sided predominance.”
From Extra-pelvic endometriosis: a review. (2020) · cites this paper as [73]
Positive histopathological confirmation of TE has been reported to range from 57% to 87.5%.
“Positive histopathological confirmation has been reported to range from 57% to 87.5%”
From Extra-pelvic endometriosis: a review. (2020) · cites this paper as [73]
The most commonly described symptom of thoracic endometriosis syndrome is catamenial pneumothorax, which occurs 24 h before or within 72 h after the onset of menses.
“The most commonly described symptom is catamenial pneumothorax, which occurs 24 h prior or within 72 h after the onset of menses [ 14 ].”
From Thoracic Endometriosis Syndrome: A Comprehensive Review and Multidisciplinary Approach to Management (2024) · cites this paper as [14]
Video-assisted thoracoscopy is the surgery of choice in patients with catamenial pneumothorax, as it is diagnostic and therapeutic.
“Video-assisted thoracoscopy is the surgery of choice in patients with catamenial pneumothorax, as it is diagnostic and therapeutic [ 14 , 27 , 58 , 66 , 67 ].”
From Thoracic Endometriosis Syndrome: A Comprehensive Review and Multidisciplinary Approach to Management (2024) · cites this paper as [14]
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- Authors
- Alifano, M., Roth, T., Broe¨t, S. C., Schussler, O., Magdeleinat, P., & Regnard, J.-F.
- Affiliations
- Assistance Publique – Hôpitaux de Paris (FR)
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 2003-09
- Volume
- 124
- Issue
- 3
- Pages
- 1004-1008
- ISSN
- 0012-3692 (ISSN-L)
- OpenAlex
- W1973642172
- Cited by
- 213
- References
- 11
- Citations by year
- 2026: 12 · 2025: 3 · 2024: 6 · 2023: 7 · 2022: 3 · 2021: 15 · 2020: 9 · 2019: 10 · 2018: 9 · 2017: 11 · 2016: 9 · 2015: 12 · 2014: 11 · 2013: 10 · 2012: 11
- FWCI
- 5.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CHEST Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pleural and Pulmonary Diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pneumothorax, Barotrauma, Emphysema
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- catamenial pneumothorax, spontaneous pneumothorax, diaphragmatic endometriosis, endometriotic implants, women of reproductive age, video-assisted thoracoscopic surgery, minithoracotomy
- MeSH terms
- Adult, Diaphragm, Endometriosis, Female, Humans, Pneumothorax, Prospective Studies, Risk Factors, Thoracic Diseases, Thoracic Surgery, Video-Assisted
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