Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report
| Autor: | Lu Han, Yafei Liu, Guanchao Ye, Sheng Yinliang, Shi-Hao Li, Bin Wu, Bo Dong, Yu Qi, Chunli Wu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Perforation (oil well) Endometriosis Catamenial pneumothorax Diaphragmatic breathing Case Report Thoracic endometriosis syndrome TES 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine 030219 obstetrics & reproductive medicine Thoracic cavity business.industry Thoracic Surgery Video-Assisted Obstetrics and Gynecology Pneumothorax Gynecology and obstetrics General Medicine Pleural cavity medicine.disease Surgery Diaphragm (structural system) Menstruation medicine.anatomical_structure Reproductive Medicine RG1-991 Female Public aspects of medicine RA1-1270 business |
| Zdroj: | BMC Women's Health BMC Women's Health, Vol 21, Iss 1, Pp 1-4 (2021) |
| ISSN: | 1472-6874 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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