Why a chest physician should be interested in abdominal pain.

S Bostoen, Dirk Van Raemdonck, D Van Raemdonck, C Dooms, Christophe Dooms
Acta clinica Belgica · 2012 · vol. 66(5) , pp. 376–8 · doi:10.2143/acb.66.5.2062590 · PMID:22145273 · W939264110
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Abstract

A 37-year-old woman presented at casualty with a 1-day history of progressive spontaneous left iliac fossa pain. She was having her menstruations for 4 days. She had no respiratory symptoms. Her medical history consisted of laparoscopic surgery for endometriosis and ovarian cysts. A very small right basal pneumothorax with visualisation of a hypervascular nodular lesion on the right diaphragm was incidentally noticed on the right diaphragm. We suspected here a catamenial pneumothorax. During video-assisted thoracoscopy the surgeon observed in the centrum tendineum of the diaphragm a small and a large perforation with partial intrathoracic herniation of the liver, but without visible diaphragmatic or pleural endometriosis. The surgeons converted to a small anterior thoracotomy in order to reinforce the large perforation with interrupted non-absorbable sutures and plication of the smaller perforation, and finally performed a mechanical pleural abrasion with a surgical pad.

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Condition tags

endometriosis

MeSH descriptors

Abdominal Pain Diaphragm Hernia, Diaphragmatic, Traumatic Liver Diseases Menstruation Pneumothorax Abdominal Pain Adult Diaphragm Diaphragm Female Hernia, Diaphragmatic, Traumatic Hernia, Diaphragmatic, Traumatic Hernia, Diaphragmatic, Traumatic Humans Liver Diseases Liver Diseases Liver Diseases Pneumothorax Pneumothorax

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