Left-sided Catamenial Pneumothorax: A Rare Clinical Entity

Abstract

Catamenial pneumothorax (CP) is an extremely rare pulmonary pathology seen in women of reproductive age, typically occurring within 72 hours from the onset of menstrual bleeding. Multiple theories have been proposed to explain the etiopathogenesis of CP; however, the exact underlying mechanism remains elusive. More than 90% of reported cases in the literature describe a right-sided presentation of pneumothorax. In this case report, we describe a rare left-sided presentation of CP and discuss the current literature on underlying etiopathogenesis, diagnostics, and available therapeutic modalities for managing this rare clinical entity.

The importance of early diagnosis and treatment of incidental tension pneumothorax during robotic assisted laparoscopy for diaphragmatic endometriosis: a report of two cases.

“…Diaphragmatic fenestrations in endometriotic tissue are described in the literature as a mechanism of pneumothorax formation, being responsible for 7.3-36% of cases of spontaneous catamenial pneumothorax ( Gil et al, 2020 ). Although it occurs on the right side in approximately 90% of cases, it can be on the left or bilateral ( Narula et al, 2018 ). Pelvic endometriosis is associated in 30- 51% of the cases ( Visouli et al, 2012 ; Segawa et al, 2011 ).…”

Case report: catamenial pneumothorax

“…The mean age at time of diagnosis is 35±7 years old 10 . It is commonly right-sided, however, there has been previous occurrence on the left or bilateral chest 12,14,15,16,17 . The diagnosis of catamenial pneumothorax can be a clinical, radiological, surgical or histological 14,15 .…”

“…The diagnosis of catamenial pneumothorax can be a clinical, radiological, surgical or histological 14,15 . Most patients present with chest pain and dyspnoea 10,12,16,18 . The authors propose eliciting the clinical quartet of chest pain, dyspnoea, menstruation onset and a past history of endometriosis.…”

A 33‐year‐old woman with chest pain

“…This is a rare cause of recurrent spontaneous pneumothorax that occurs in women of reproductive age without known respiratory disease, usually and within 72 hours of the menstrual period, and may be associated with thoracic endometriosis 1 . Most cases occur on the right and may occasionally have a concomitant hemothorax 2,3 . The diagnosis is clinical but may be confirmed with video‐assisted surgery.…”