RECURRENT ENDOMETRIOSIS-ASSOCIATED PNEUMOTHORAX: CAUSES AND PREVENTION STRATEGIES

In: SCIENTIFIC PRACTICE: MODERN AND CLASSICAL RESEARCH METHODS · 2025 · doi:10.36074/logos-14.02.2025.083 · W4408514708
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This paper reviews the clinical approach and management of catamenial pneumothorax, a condition characterized by recurrent air in the pleural space that coincides with menstruation. It synthesizes literature to highlight diagnostic challenges arising from the complex visualization and pathological verification required for endometriosis, noting prevalence rates vary significantly between asymptomatic women and those with pelvic pain. The authors discuss surgical interventions via laparoscopic or thoracoscopic access and emphasize the role of postoperative hormonal therapies in reducing recurrence rates of these thoracic manifestations. This paper is centrally about endometriosis — specifically its rare thoracic manifestation known as thoracic endometriosis syndrome presenting as catamenial pneumothorax.

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Abstract

The current definition of endometriosis is described as the presence of endometrioid tissue outside the uterus [10]. To establish a clinical diagnosis, foci of endometriosis are visualised, in particular through laparoscopic or thoracoscopic accesses, and pathological verification is performed. The complexity of such verification leads to problems in determining its prevalence, so its rates remain unclear. According to Shafrir et al. (2018), this value varies from 2-11% in women with no complaints to 5-21% among those hospitalised with pelvic pain [7].
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The current definition of endometriosis is described as the presence of endometrioid tissue outside the uterus [10]. To establish a clinical diagnosis, foci of endometriosis are visualised, in particular through laparoscopic or thoracoscopic accesses, and pathological verification is performed. The complexity of such verification leads to problems in determining its prevalence, so its rates remain unclear. According to Shafrir et al. (2018), this value varies from 2-11% in women with no complaints to 5-21% among those hospitalised with pelvic pain [7]. - Korom, S., Canyurt, H., Missbach, A., Schneiter, D., Kurrer, M. O., Haller, U., Keller, P. J., Furrer, M., & Weder, W. (2004). Catamenial pneumothorax revisited: clinical approach and systematic review of the literature. The Journal of thoracic and cardiovascular surgery, 128(4), 502–508. https://doi.org/10.1016/j.jtcvs.2004.04.039 - Laganà, A. S., & Naem, A. (2022). The pathogenesis of endometriosis: Are endometrial Stem/Progenitor cells involved? In Stem cell biology and regenerative medicine (pp. 193–216). https://doi.org/10.1007/978-3-030-90111-0_9 - Moroz, V., Kovalchuk, O., Motliakh, V., & Babenko M. (2024). Features of diagnosis and treatment of Endometriosis-Associated Pneumothorax (Clinical case). Tuberculosis Lung Diseases HIV Infection, 4, 68–74. https://doi.org/10.30978/tb2024-4-68 - Nezhat, C., Lindheim, S. R., Backhus, L., Vu, M., Vang, N., Nezhat, A., & Nezhat, C. (2019). Thoracic Endometriosis Syndrome: A Review of Diagnosis and Management. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 23(3), e2019.00029. https://doi.org/10.4293/JSLS.2019.00029 - Pratomo, I. P., Putra, M. A., Bangun, L. G., Soetartio, I. M., Maharani, M. A. P., Febriana, I. S., Soehardiman, D., Prasenohadi, P., & Kinasih, T. (2023). Video-assisted surgical diagnosis and pleural adhesion management in catamenial pneumothorax: A case and literature review. Respirology case reports, 11(4), e01123. https://doi.org/10.1002/rcr2.1123 - Qavi, A., Basak, P., & Jesmajian, S. (2019). THORACIC ENDOMETRIOSIS SYNDROME PRESENTING AS RECURRENT CATAMENIAL PNEUMOTHORAX. CHEST Journal, 156(4), A1428. https://doi.org/10.1016/j.chest.2019.08.1272 - Shafrir, A. L., Farland, L. V., Shah, D. K., Harris, H. R., Kvaskoff, M., Zondervan, K., & Missmer, S. A. (2018). Risk for and consequences of endometriosis: A critical epidemiologic review. Best practice & research. Clinical obstetrics & gynaecology, 51, 1–15. https://doi.org/10.1016/j.bpobgyn.2018.06.001 - Tsuboshima, K., Kurihara, M., Okumura, G., Ohashi, K., Takahashi, K., Shiko, Y., Ozawa, Y., & Seyama, K. (2023). Postoperative hormonal therapies reduce the recurrence of thoracic endometriosis-related pneumothorax. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 64(4), ezad331. https://doi.org/10.1093/ejcts/ezad331 - Velagapudi, R. K., & Egan, J. P. (2021). Thoracic Endometriosis: a Clinical Review and Update of Current and Evolving Diagnostic and Therapeutic Techniques. Current Pulmonology Reports, 10(1), 22–29. https://doi.org/10.1007/s13665-021-00269-z - Zondervan, K. T., Becker, C. M., & Missmer, S. A. (2020). Endometriosis. The New England

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