Endometriosis-related pneumothorax

Е. А. Drobyazgin, Yu. V. Chikinev, K.I. Tscherbina, Н. М. Пасман, Ya. L. Manakova, Tatyana Veretelnikova
In: Endoscopic Surgery · 2024 · vol. 30(3) , pp. 48 · doi:10.17116/endoskop20243003148 · W4399755270
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study evaluated diagnosis and treatment for 10 patients with endometriosis-associated pneumothorax, finding videothoracoscopy effective, with diaphragm lesions in 70% and recurrence in 30%.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

The paper evaluates diagnostic and treatment outcomes for endometriosis-associated pneumothorax in 10 women (ages 28–47) treated in a thoracic surgery department from 2011 to December 2022, with initial emergency management including pleural drainage and subsequent CT-based assessment. Intraoperatively, all patients underwent thoracoscopic surgery with pleural revision, and 7/10 showed diaphragmatic lesions (fenestrated perforations and/or pigmented nodules), though only 3 had histopathologic confirmation of endometriosis; imaging typically confirmed pneumothorax with lung collapse and no diaphragmatic changes in most cases, with one patient showing suspected diaphragmatic fenestration via herniation findings. Postoperative courses were uncomplicated, with prolonged hormonal suppression used in most patients and recurrences occurring in 3 patients after 3–4 years, prompting re-intervention and, in two cases, pleurodesis and pleurectomy. The study is limited by its small sample size and partial histologic verification, meaning diagnostic certainty relied heavily on clinical history, operative findings, and indirect pathology. This paper is centrally about endometriosis — it focuses specifically on endometriosis-associated pneumothorax.

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Abstract

Objective. The aim of the study — evaluation of the results of diagnosis and treatment of patients with endometriosis-associated pneumothorax. Material and methods. During the period from 2011 to December 2022, 10 patients aged 28 to 47 years with endometriosis-associated pneumothorax were treated. The duration of the disease, established anamnestically, ranged from 2 to 10 years. In 100% of cases, the patients also had genital forms of endometriosis, in 2 (20%) in combination with myoma and in 5 (50%) with endometrial hyperplastic processes. Two (20%) patients had previously had gynecological operations on the uterus or appendages: hysterectomy — 1, ovarian surgery — 1. Results. In all cases, surgical treatment was performed: videothoracoscopy. Seven (70%) patients had fenestrated perforations (4) and pigmented nodules (3) on the central tendon of the diaphragm. In 3 (30%) patients, endometriotic changes were associated with bullous lung emphysema. The volume of surgical treatment was determined depending on the extent of damage to the diaphragm and lung tissue. The postoperative period was uneventful in all cases. The chest drains were removed 2—3 days after the operation. In nine cases, the patients underwent courses of therapy lasting from 12 to 60 months. Seven patients underwent interventions for genital endometriosis. Pneumothorax recurrence occurred in 3 patients: 3 years after thoracoscopic intervention (in 2 patients) and 4 years (in 1) after thoracoscopic intervention. Conclusion. Endometriosis associated pneumothorax is a multidisciplinary problem. Therapy of genital endometriosis with the achievement of drug-induced amenorrhea allows achieving remission and, in most cases, avoiding relapses of endometriosis-associated pneumothorax.

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endometriosis

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