Acute abdominal pain is a frequent event in the paediatric population and appendicitis is the most common cause. Abdominal lymphangiomas occur most frequently in the mesenterium and are usually asymptomatic. Nevertheless, they can manifest as acute abdomen, needing surgical treatment. We report the case of a 5-year-old female operated on due to suspicion of acute abdomen. The pathological lesion was surgically removed during the second operation. The differential diagnosis of acute abdomen should be initially focused on the most common abdominal diseases. However, rare cases, like the presented one, must also be taken into consideration. Ultrasound examination plays important role in the initial differentiation of the causes of abdominal pain.
Catamenial pneumothorax (CP) is an uncommon disease related to thoracic endometriosis or diaphragmatic perforation. It is defined as an occurrence of spontaneous pneumothorax around the time of menstruation in the population of women of reproductive age with no other lung diseases. Catamenial pneumothorax is often misdiagnosed and classified as a spontaneous pneumothorax, and no in-depth gynaecological diagnostic is performed. Here we present 3 cases of female patients admitted to the Department of Thoracic Surgery with the aim of surgical treatment of recurrent CP. In all 3 cases, a temporal association between pneumothorax and menstruation was identified. In 2 presented cases the patients were diagnosed with endometriosis and other gynaecological diseases. The previous incidents of CP were treated conservatively, with suction drainage of the pleural cavity or with thoracocentesis, but the treatment did not prevent relapses. In the Department of Thoracic Surgery, each patient was operated on with the use of video-assisted thoracoscopic surgery, which is considered to be a good therapeutic option. In the case of 2 patients the surgery eliminated the relapses, 1 patient required radical lung decortication. The literature on the subject indicates the potential benefits of hormonal treatment of CP. It is suggested that using such pharmacological treatment may reduce the risk of relapse after surgery.
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