Catamenial Pneumothorax: An Example of a Porous Diaphragm-Case Report

Catamenial pneumothorax is currently considered to be a very unusual clinical condition. It has been defined as a spontaneous and recurrent pneumothorax occurring within 72h from the onset of menstruation. The first attack usually occurs in women during the 3rd or 4th decade of life, and is mostly involved in the right lung. However, the exact incidence, pathogenic mechanisms, and optimal management of catamenial pneumothorax remain unclear. We report a 36-year-old female patient with right catamenial pneumothorax that recurred 5 times, and who was found, at surgery, to have many diaphragmatic holes without signs of diaphragmatic or thoracic endometriosis. After the diaphragmatic holes had been closed with sutures, the patient no longer suffered recurrent right-side pneumothorax. Thus, a consideration of catamenial pneumothorax in women of reproductive age with recurrent spontaneous pneumothorax is warranted. Evaluation of the diaphragm is necessary, and if holes are seen, they should be sutured closed to prevent recurrence.