Catamenial Pneumothorax

Çelık, Seden; Erşen, Ezel

doi:10.5772/intechopen.82564

Cited by 3 publications

(2 citation statements)

References 54 publications

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“…Pleurodesis, which can be accomplished chemically with talc or mechanically with pleural abrasion and partial pleurectomy, decreases the recurrence rate of CP after VATS by 20%–25% ( 16 , 23 – 26 ). Proper CP diagnosis, especially if done with histological confirmation of the endometrial foci in the pleura, pulmonary parenchyma, or diaphragm, may be crucial to the patient even after surgical treatment of pneumothorax, because hormonal therapy may contribute to the avoidance of CP recurrence ( 27 , 28 ).…”

Section: Introductionmentioning

confidence: 99%

Catamenial pneumothorax: Not only VATS diagnosis

et al. 2023

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BackgroundCatamenial pneumothorax (CP) is a rare type of spontaneous, recurring pneumothorax occurring in women, from the day before menstruation until 72 hours after its beginning. Conservative treatment is generally associated with recurrence of CP. Video-assisted thoracic surgery (VATS) approach allows not only to obtain diagnosis but also to guide definitive treatment of causing lesions, such as ectopic endometrial implants or diaphragmatic defects and fenestrations. We report our experience in VATS management of CP to focus on its role in CP.Materials and methodsIn this retrospective observational study, we collected data from women referred to our center for CP, from January 2019 to April 2022. All patients underwent VATS approach, with muscle-sparing thoracotomy when diaphragmatic fenestrations were detected, to perform selective diaphragmatic plication and/or partial diaphragmatic resection. Results were analyzed in terms of pneumothorax recurrence after surgical treatment. All patients were referred to gynecologists for medical therapy.ResultsEight women (median age 36 years, range: 21–45), all with right side CP, were included; three already had pelvic endometriosis and two had already undergone lung apicectomy at other institutions. VATS allowed us to detect diaphragmatic fenestrations in seven patients (87.5%) and apical bullae in five (62.5%). Apicectomy was performed in five cases (62.5%), selective diaphragmatic plication in two (25%), and partial diaphragmatic resection in five (62.5%). Chemical pleurodesis with talc was performed in all to minimize the risk of recurrence. Pathological diagnosis of endometriosis on the resected diaphragm was achieved in five patients (62.5%). No recurrence occurred, except for one woman who stopped medical treatment for endometriosis.ConclusionsIn the management of patients with CP, VATS should be recommended not only to obtain an explorative diagnosis of ectopic endometrial implants or diaphragmatic fenestrations but also to allow the most appropriate surgical treatment and obtain pathological specimens for confirmation and definitive diagnosis of thoracic endometriosis. Medical therapy to achieve ovarian rest is mandatory in the postoperative period and should not be discontinued.

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Section: Introductionmentioning

confidence: 99%

Catamenial pneumothorax: Not only VATS diagnosis

et al. 2023

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“…The condition is often misdiagnosed and classified as spontaneous pneumothorax due to lack of analysis of patients’ menstrual history and failure to perform a routine intraoperative diaphragm inspection [ 3 ]. Proper CP diagnosis may be crucial to the patient even after surgical treatment of pneumothorax because hormonal therapy may contribute to the avoidance of recurrence of CP incidents [ 4 ]. Here we present 3 cases of recurrent CP treated surgically in the Thoracic Surgery Ward and briefly summarize the current state of knowledge on the subject.…”

Section: Introductionmentioning

confidence: 99%

Catamenial pneumothorax – are there benefits of cooperation between the surgeon and the gynaecologist?

Miedziarek¹,

Kasprzyk²

2022

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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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Right hemothorax secondary to endometriosis

Ijasan

Upeh

2020

Curr Med Issues

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Catamenial Pneumothorax

Cited by 3 publications

References 54 publications

Catamenial pneumothorax: Not only VATS diagnosis

Catamenial pneumothorax: Not only VATS diagnosis

Catamenial pneumothorax – are there benefits of cooperation between the surgeon and the gynaecologist?

Right hemothorax secondary to endometriosis

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