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Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report
BACKGROUND: Catamenial pneumothorax is characterized by spontaneous recurring pneumothorax during menstruation, which is a common clinical manifestation of thoracic endometriosis syndrome. There are still controversies about its pathogenesis. CASE PRESENTATION: A 43-year-old woman with a history of...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8059314/ https://www.ncbi.nlm.nih.gov/pubmed/33879147 http://dx.doi.org/10.1186/s12905-021-01318-0 |
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author | Dong, Bo Wu, Chun-Li Sheng, Yin-liang Wu, Bin Ye, Guan-Chao Liu, Ya-Fei Li, Shi-Hao Han, Lu Qi, Yu |
author_facet | Dong, Bo Wu, Chun-Li Sheng, Yin-liang Wu, Bin Ye, Guan-Chao Liu, Ya-Fei Li, Shi-Hao Han, Lu Qi, Yu |
author_sort | Dong, Bo |
collection | PubMed |
description | BACKGROUND: Catamenial pneumothorax is characterized by spontaneous recurring pneumothorax during menstruation, which is a common clinical manifestation of thoracic endometriosis syndrome. There are still controversies about its pathogenesis. CASE PRESENTATION: A 43-year-old woman with a history of endometriosis came to our hospital due to recurring pneumothorax during menstruation. Uniportal Video-assisted Thoracoscopic Surgery (VATS) exploration was performed on the eve of menstruating. We thoroughly explored the diaphragm, visceral and parietal pleura: The lung surface was scattered with yellowish-brown implants; no bullae were found; multiple diaphragmatic defects were found on the dome. And surprisingly, we caught a fascinating phenomenon: Bubbles were slipping into pleural cavity through diaphragmatic defects. We excised the diaphragmatic lesions and wedge resected the right upper lung lesion; cleared the deposits and flushed the thoracic cavity with pure iodophor. Diaphragmatic lesions confirmed the presence of endometriosis, and interestingly enough, microscopically, endometrial cells were shedding with impending menses. After a series of intraoperative operations and postoperative endocrine therapy, the disease did not recur after a period of follow-up. CONCLUSION: We have witnessed the typical signs of catamenial pneumothorax at the accurate timing: Not only observed the process of gas migration macroscopically, but also obtained pathological evidence of diaphragmatic periodic perforation microscopically, which is especially precious and confirms the existing theory that retrograde menstruation leads to diaphragmatic endometriosis, and the diaphragmatic fenestration is obtained due to the periodic activities of ectopic endometrium. |
format | Online Article Text |
id | pubmed-8059314 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-80593142021-04-21 Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report Dong, Bo Wu, Chun-Li Sheng, Yin-liang Wu, Bin Ye, Guan-Chao Liu, Ya-Fei Li, Shi-Hao Han, Lu Qi, Yu BMC Womens Health Case Report BACKGROUND: Catamenial pneumothorax is characterized by spontaneous recurring pneumothorax during menstruation, which is a common clinical manifestation of thoracic endometriosis syndrome. There are still controversies about its pathogenesis. CASE PRESENTATION: A 43-year-old woman with a history of endometriosis came to our hospital due to recurring pneumothorax during menstruation. Uniportal Video-assisted Thoracoscopic Surgery (VATS) exploration was performed on the eve of menstruating. We thoroughly explored the diaphragm, visceral and parietal pleura: The lung surface was scattered with yellowish-brown implants; no bullae were found; multiple diaphragmatic defects were found on the dome. And surprisingly, we caught a fascinating phenomenon: Bubbles were slipping into pleural cavity through diaphragmatic defects. We excised the diaphragmatic lesions and wedge resected the right upper lung lesion; cleared the deposits and flushed the thoracic cavity with pure iodophor. Diaphragmatic lesions confirmed the presence of endometriosis, and interestingly enough, microscopically, endometrial cells were shedding with impending menses. After a series of intraoperative operations and postoperative endocrine therapy, the disease did not recur after a period of follow-up. CONCLUSION: We have witnessed the typical signs of catamenial pneumothorax at the accurate timing: Not only observed the process of gas migration macroscopically, but also obtained pathological evidence of diaphragmatic periodic perforation microscopically, which is especially precious and confirms the existing theory that retrograde menstruation leads to diaphragmatic endometriosis, and the diaphragmatic fenestration is obtained due to the periodic activities of ectopic endometrium. BioMed Central 2021-04-20 /pmc/articles/PMC8059314/ /pubmed/33879147 http://dx.doi.org/10.1186/s12905-021-01318-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Dong, Bo Wu, Chun-Li Sheng, Yin-liang Wu, Bin Ye, Guan-Chao Liu, Ya-Fei Li, Shi-Hao Han, Lu Qi, Yu Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report |
title | Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report |
title_full | Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report |
title_fullStr | Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report |
title_full_unstemmed | Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report |
title_short | Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report |
title_sort | catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8059314/ https://www.ncbi.nlm.nih.gov/pubmed/33879147 http://dx.doi.org/10.1186/s12905-021-01318-0 |
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