[Catamenial hemothorax: Results of 11 operated cases]

R. Ouede, Ouede R, Kone Z, Z. Koné, Z Kone, Landry Kohou-Koné, Kohou-Kone LL, L L Kohou-Kone, Kouacou MG, Maurice Gabin Kouacou, M G Kouacou, G Okon, Gérard Okon, Okon G, B A Demine, Demine BA, Blaise Demine, N'guessan E, E N'guessan, E. Nguessan, Kendja KF, K F Kendja, Yves Tanauh, Tanauh YR, Y R Tanauh
Revue des maladies respiratoires · 2022 · vol. 39(3) , pp. 221–227 · doi:10.1016/j.rmr.2021.12.009 · PMID:35219560 · W4213459017
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This case series reports on 11 patients who underwent surgery for catamenial hemothorax, a rare condition involving recurrent blood in the pleural space associated with menstruation.

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Abstract

OBJECTIVE: To report our therapeutic approach toward catamenial hemothorax. PATIENTS AND METHODS: This retrospective study from January 1994 to November 2018 concerned patients operated under general anesthesia for catamenial hemothorax. A posterolateral thoracotomy approach was implemented either directly or after primary videothoracoscopy. Six-month hormone therapy was systematically prescribed postoperatively. The result was assessed in terms of occurrence or non-occurrence of hemothorax upon resumption of menses after discontinuation of hormone therapy. RESULTS: Eleven patients were selected, with an average age was 32years (25-41). Catamenial hemothorax was associated with hemorrhagic ascites in 5 cases. Endometriotic plaques in the form of diaphragmatic fenestrations were found nine times and were resected (1 case) or covered by a synthetic non-absorbable patch (8 cases). Pleural symphysis completed the surgical procedures. The one hormone used was triptorelin. Mortality was zero. Mean postoperative hospital stay was 10.24days and mean follow-up was 3.5years. One patient was lost to follow-up at 3months. One hemothorax recurrence was observed after discontinuation of hormone therapy at 4months [1], and repeated pleural punctures were carried out while awaiting revision surgery. The five cases of ascites recurred and the patients were monitored in the gynecology unit. CONCLUSION: In patients suffering from catamenial hemothorax with diaphragmatic fenestrations, we recommend phrenoplasty using synthetic patches associated with pleural talcage and 6-month complementary concomitant hormone therapy.

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MeSH descriptors

Hemothorax Hemothorax Hemothorax Hemothorax Pneumothorax Pneumothorax Pneumothorax Adult Adult Ascites Ascites Ascites Female Female Hormones Hormones Humans Humans Recurrence Recurrence

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