Respir Case Rep. 2023; 12(1): 1-6 | DOI: 10.5505/respircase.2023.09815

Catamenial Pneumothorax and Skin Endometriosis: A Case Report

Ayman Ahmed, Fahad Al Amoudi, Abdulnasir Batuk, Sharafeldin Elaoni, Ahmed Shahin, Ataa Albaroudi
King Abdullah Medical City, Department of Thoracic Surgery, Holy Capital Makkah, Saudi Arabia

Catamenial pneumothorax (CP) is an uncommon disease that is challenging to diagnose and manage. It is characterized by recurrent episodes of spontaneous pneumothorax occurring periodically within 72 hours of menses in women of childbearing age. Treatment typically includes video-assisted thoracic surgery (VATS) and hormonal treatment. This case report is of a 37-year-old female who was presented with her fourth episode of recurrent right-sided pneumothorax, her two-year status post-VATS bullectomy, chemical and mechanical pleurodesis, and dienogest treatment. This case report details the natural history of a CP presentation with a high index of suspicion to diagnose, meticulous surgical exploration of the hemithorax, looking particularly for bullae and diaphragmatic pleural endometriosis or fenestrations, and application of both mechanical and chemical pleurodesis to prevent a recurrence. This report should encourage the combined adoption of chemical and mechanical pleurodesis during VATS in CP patients suffering from repeated recurrence.

Keywords: Catamenial pneumothorax (CP), Endometriosis, Talc pleurodesis, VATS

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Katamenial Pnömotoraks ve Cilt Endometriozisi: Olgu Sunumu

Ayman Ahmed, Fahad Al Amoudi, Abdulnasir Batuk, Sharafeldin Elaoni, Ahmed Shahin, Ataa Albaroudi
Kral Abdullah Týp Þehri, Göðüs Cerrahisi Anabilim Dalý, Kutsal Baþkent Mekke, Suudi Arabistan

Katemenial pnömotoraks, periyodik olarak menstürasyonu takip eden 72 saat içinde meydana gelen ve tekrarlayan spontan pnömotoraks ataklarý ile karakterize, teþhis ve tedavisi zor olan nadir görülen bir durumdur. Burada, VATS büllektomi, kimyasal ve mekanik plörodezis, dienogest tedavileri sonrasý iki yýl içerisinde dördüncü rekürren sað pnömotoraks ataðý ile baþvuran 37 yaþýnda bir kadýn hasta sunulmaktadýr. Tedavisi, tüp torakostomi, sað vats ile alt ve orta lob büllektomi, diafragma açýlmasý, ektopik diafragmatik endometrial dokunun rezeksiyonu, apikal wedge rezeksiyon, parietal plevra abrazyonu ve talk ile plörodezisden oluþmaktadýr. Bu olgu sunumda, tanýda yüksek þüphe, titiz cerrahi eksplorasyon, özellikle bülleri ve diafragmatik plevral endometrium dokusunun araþtýrýlmasýný, hem mekanik hem de kimyasal plörodezis uygulamalarýný gerektiren bir katemenial pnömotoraks olgusunun doðal seyrini detaylarý ile ortaya koymuþtur. Bu sunum, yineleyen nükslere mazur kalan katemenial pnömotorakslý hastalarda VATS ile birlikte kimyasal ve mekanik plörodezisin kombine kullanýlmasý konusunda yol gösterici olabilir.

Anahtar Kelimeler: Katamenial pnömotoraks, Endometriozis, Talk plöredez, VATS

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