Catamenial pneumothorax

This case report and literature review examines the pathogenesis of catamenial pneumothorax, analyzing 69 previously reported English-language cases alongside a new patient evaluated via computed tomography. The authors outline four primary theoretical mechanisms for the condition: air passage through diaphragmatic defects from the genital tract, rupture of subpleural blebs, presence of intrathoracic endometrial implants, and prostaglandin-induced bronchiolar constriction leading to alveolar rupture. While evidence is presented for each theory, the paper notes that the exact pathogenesis remains incompletely elucidated despite extensive case material. This paper is centrally about endometriosis, specifically addressing thoracic manifestations where ectopic endometrial tissue or related physiological changes cause recurrent pneumothorax coinciding with menstruation.

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