Case report
Life-Threatening Endometriosis-Related Hemopneumothorax

https://doi.org/10.1016/j.athoracsur.2005.10.002Get rights and content

Catamenial pneumothorax is a relatively rare condition, generally of mild to moderate severity. We report the case of a 29-year-old woman who experienced an episode of life threatening right-sided hemopneumothorax in association with menses. She had already been operated on for recurrent pneumothorax. Treatment of the current episode included urgent tube thoracostomy and iterative thoracotomy, together with lung wedge resection, parietal pleurectomy, and partial diaphragmatic excision. Pathologic examination revealed endometrial implants massively involving the diaphragm, the pleura, and the lung parenchyma. The present report shows that endometriosis-related pneumothorax may be extremely severe. The multiple localizations of endometrial implants in this case may provide a support to the different pathogenic theories of endometriosis-related pneumothorax.

Section snippets

Comment

Endometriosis-related pneumothorax was considered as an extremely rare entity until recently. Several reports and some surgical series have been recently published [1, 4], testifying either an increased incidence of the disease or its improved recognition. However, controversies still remain about the exact cause and pathogenesis.

It is believed that some cases of catamenial pneumothorax could be secondary to rupture of either bullae or alveoli after a vascular or bronchiolar constriction, or

References (7)

There are more references available in the full text version of this article.

Cited by (21)

  • Pleural effusion secondary to endometriosis: A systematic review

    2023, American Journal of the Medical Sciences
  • Thoracic Endometriosis: A Review Comparing 480 Patients Based on Catamenial and Noncatamenial Symptoms

    2022, Journal of Minimally Invasive Gynecology
    Citation Excerpt :

    The final exclusion was made of cases in which the patient's symptomatology was not presented clearly or endometriosis was an incidental operative finding. The final exclusion yielded 240 articles and 480 patients for inclusion in this review (Fig. 1) [7–246]. The patients were categorized for assessment into 2 groups depending on whether the presentation of their symptoms was catamenial (n = 419) or noncatamenial (n = 61).

  • Bilateral catamenial hemopneumothorax: Diagnostic & management challenges

    2019, International Journal of Surgery Case Reports
    Citation Excerpt :

    Thoracic endometriosis syndrome (TET) remains a commonly missed, or underdiagnosed disease [5]. Increased awareness of this clinical entity and higher index of suspicion should be in any female in her reproductive age presenting with pneumothorax [6]. However, controversies still remain in regards to its pathogenesis.

  • Endometriosis Presenting as Bloody Ascites and Shock

    2010, Journal of Emergency Medicine
    Citation Excerpt :

    The most frequent complaint is pelvic pain; however, unusual symptoms, such as cyclic hemoptysis, headache, pleural effusion, or cutaneous manifestations can present (3–5). Moreover, life-threatening presentations, such as subarachnoid hemorrhage and hemopneumothorax, have also been reported (4,6). Patients with massive ascites caused by endometriosis have been reported, but none presented with hypovolemic shock (1).

View all citing articles on Scopus
View full text