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Ann Thorac Surg 2002;74:563-565
© 2002 The Society of Thoracic Surgeons


Case report

Catamenial pneumothorax: chest X-ray sign and thoracoscopic treatment

Thierry Roth, MDa, Marco Alifano, MD*a, Olivier Schussler, MDa, Pierre Magdaleinat, MDa, Jean-François Regnard, MDa

a Unité de Chirurgie Thoracique, Hôtel-Dieu, AP-HP, Universitè Paris VI, Paris, France

Accepted for publication April 1, 2002.

* Address reprint requests to Dr Alifano, Chirurgie Thoracique, Hôtel-Dieu, 1, Place du Parvis Nôtre-Dame, 75181 Paris Cedex 04, France
e-mail: marcoalifano{at}yahoo.com

We report the case of a 25-year-old woman with recurrent right-sided catamenial pneumothorax. At thoracoscopy, the diaphragm presented several violet implants with holes. The presence of diaphragmatic endometrial implants was confirmed at pathologic examination. Re-review of the preoperative chest x-ray film showed 8 x 5 and 1 x 1 mm bubbles at the level of the right diaphragm associated with the homolateral pneumothorax, thus suggesting that passage of air from the genital tract through the diaphragm was responsible for the pneumothorax. This may further clarify the pathogenesis of catamenial pneumothorax which remains controversial in the literature.




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