Thoracic endometriosis syndrome manifesting as atraumatic haemothorax causing difficult ventilation under general anaesthesia

Mark Peterzan, Peterzan M, Toby Reynolds, Reynolds T, Dulay K, Kamaljit Dulay, Wooldridge R, Rachel Wooldridge
BMJ case reports · 2012 · vol. 2012 , pp. bcr2012007206 · doi:10.1136/bcr-2012-007206 · PMID:23257939 · PMC4543866 · W2007414578
article OA: bronze CC0 ⤵ 6 in-corpus citations
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This case report describes a 31-year-old woman who presented with atraumatic hemothorax causing ventilation difficulties under general anesthesia, ultimately diagnosed as thoracic endometriosis after thoracotomy.

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Abstract

A 31-year-old woman underwent elective hysteroscopy and laparoscopy for investigation of primary infertility. The procedure was abandoned owing to intraoperative desaturation and reduced right-sided chest movement. Postoperative chest x-ray showed an opacified right hemithorax with tracheal deviation to the left. Retrospectively on direct questioning, she admitted to dry cough, mild dyspnoea and significant weight loss. Diagnostic thoracocentesis and contrast CT scan confirmed heavily blood-stained exudative pleural effusion but were otherwise non-diagnostic. After chest drain insertion, 4.6 litre drained but a hydropneumothorax developed upon drain removal, with no improvement on repeat drain insertion. Right video-assisted thoracic surgery was performed, converted to thoracotomy, with repair of diaphragmatic fenestrations, pleurectomy and decortication of trapped lung undertaken. Histological examination of samples of pleura and lung cortex was pathognomic of endometriosis. She was started on norethisterone with no recurrence to date.

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Condition tags

endometriosisthoracic_endometriosisinfertility

MeSH descriptors

Anesthesia, General Endometriosis Endometriosis Hemothorax Intraoperative Complications Intraoperative Complications Lung Diseases Lung Diseases Pleural Diseases Pleural Diseases Respiration Disorders Adult Endometriosis Female Hemothorax Humans Intraoperative Complications Lung Diseases Pleural Diseases Respiration Disorders

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (13)

Cited by (6)

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