Clinical presentation and treatment of catameinal pneumothorax and endometriosis-related pneumothorax

Ludovic Fournel, Antonio Bobbio, Bobbio A, Robin E, Edouard Robin, Canny-Hamelin E, Emelyne Canny-Hamelin, Alifano M, Marco Alifano, Jean-François Regnard, Regnard JF, Jean‐François Régnard
Expert review of respiratory medicine · 2018 · vol. 12(12) , pp. 1031–1036 · doi:10.1080/17476348.2018.1551133 · PMID:30457394 · W2901703014
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This paper describes the unspecific clinical presentation and imaging of catamenial and endometriosis-related pneumothorax in women, recommending multidisciplinary management including surgery, pleurodesis, hormonal blockade, and follow-up to address high recurrence rates.

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Abstract

Introduction: Catamenial pneumothorax (CP) is defined as a recurrent spontaneous pneumothorax occurring in females of reproductive age. In the 'perimenstrual period,' it is still considered relatively rare although accounting for 20-35% of spontaneous pneumothoraces occurring in premenopausal women. It is the most frequent manifestation of thoracic endometriosis, which can also cause pneumothorax during the intermenstrual period (TER non-CP). Areas covered: In this article, we review and comment the clinical presentation, etiopathogenesis, diagnostic criteria, and therapeutic management of CP and TER non-CP. We particularly emphasize on the surgical optimal treatment and associated multidisciplinary care and follow-up. Electronic databases, mostly PubMed, were used for searching terms including 'catamenial pneumothorax' and 'thoracic endometriosis.' Expert commentary: Clinical presentation and imaging of CP and TER non-CP are often unspecific except for possible visualization of endometriosis foci or diaphragmatic lesions at computed tomography-scan or magnetic resonance imaging. Thus, we recommend careful interrogatory and intraoperative inspection for appropriate diagnosis and treatment of pneumothorax in women. Despite better awareness of surgical teams, CP and TER-non CP are still associated with high rates of postoperative recurrence (around 30%). We strongly advocate for a multidisciplinary management including early surgical and chemical pleurodesis, resection of all visible endometriosis-related lesions, hormonal blockade, and prolonged follow-up.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Pneumothorax Pneumothorax Adult Adult Endometriosis Endometriosis Female Female Humans Humans Pneumothorax Pneumothorax Pneumothorax Recurrence Recurrence Tomography, X-Ray Computed Tomography, X-Ray Computed

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