Authors: Leong, Annabelle C.; Coonar, Aman S.; Lang-Lazdunski, Loïc

Source: Annals of The Royal College of Surgeons of England, Volume 88, Number 6, October 2006 , pp. 547-549(3)

Publisher: The Royal College of Surgeons of England

Abstract:

Catamenial pneumothorax is defined as spontaneous pneumothoraces occurring within 72 h before or after onset of menstruation. It is rare but clinical index of suspicion should be high in ovulating women with spontaneous pneumothoraces. The mechanism is unclear but is thought to involve pre-existing or acquired diaphragmatic defects and endometrial implants. Traditional therapy involving hormonal treatment or surgical pleurodesis alone is associated with high rates of recurrence. A series of four patients with catamenial pneumothorax managed at our institution is presented to highlight the condition to various surgical specialties to whom it may present, and to emphasise the importance of both surgical and hormonal interventions in preventing recurrence. Each patient underwent video-assisted thoracoscopic inspection of the diaphragm, mechanical pleurodesis and, most importantly, repair of diaphragmatic defects with an artificial mesh. Surgical treatment was strictly followed by a course of gonadotrophin-releasing hormone analogue therapy in three patients, with no recurrence to date (longest follow-up 45 months). The fourth patient suffered a postoperative recurrence when hormonal treatment was delayed for 6 weeks, stressing the importance of hormonal treatment in conjunction with surgery.

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Keywords: CATAMENIAL PNEUMOTHORAX; VIDEOTHORACOSCOPY; DIAPHRAGM; ARTIFICIAL MESH; ENDOMETRIOSIS

Document Type: Research article

DOI: http://dx.doi.org/10.1308/003588406X130732

Affiliations: 1: Department of Thoracic Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, Kng's College, London, UK

Publication date: 2006-10-01

More about this publication?

• The Annals of The Royal College of Surgeons of England is the official journal of the College and is published eight times a year in January, March, April, May, July, September, October and November. The main aim of the journal is to publish high quality, peer-reviewed papers that relate to all branches of surgery.
  
  The Annals also includes letters and comments, a regular technical section, NICE news, controversial topics, CORESS feedback, book reviews and the best trainee presentations from England and Wales. The editorial board is composed of members of the College Council and experts from across the surgical specialties.
  
  Archive issues of the Annals of The Royal College of Surgeons of England are available via the PubMed Central database
  
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