[Catamenial pneumothorax with persistent air leak]

Abstract

Catamenial pneumothorax is a spontaneous recurrent pneumothorax that occurs in women of reproductive age and in temporal relationship with the menses. It usually occurs within 24 hours before or 72 hours after the start of the menstrual cycle; however, multiple variations have been described in terms of the temporal relationship. To date, it is considered a rare condition; this may be justified by the limited available knowledge on this disease leading to misdiagnosis. Often, making a diagnosis of catamenial pneumothorax is complicated; it mainly depends on the medical history; also, it may be a surgical or histopathological diagnosis. Management strategies for catamenial pneumothorax may include combinations of hormonal therapy, pleurodesis, lung parenchyma resection, and diaphragm resection/repair. The aim of reporting this atypical case of catamenial pneumothorax is to highlight the relevance of having the adequate knowledge on this entity so it does not go unnoticed despite its apparent low incidence.

Figura 1. Radiografía de tórax que muestra neumotórax de distribución atípica laterobasal y apical derecho (flechas amarillas) con signos de adherencia del lóbulo superior derecho (flechas azules) en relación con pleurectomía previa.

Figura 2. Visión videotoracoscópica intraoperatoria. Se observa bleb (flecha amarilla) localizado en la encrucijada cisural. LSD: lóbulo superior derecho. LM: lóbulo medio. LID: lóbulo inferior derecho.

Figura 3. Visión videotoracoscópica intraoperatoria. A. Fenestraciones diafragmáticas. B. Plicatura y cierre de la fenestración con punto simple de seda 3/0. C. Resultado final del cierre de las fenestraciones diafragmáticas. D. Pleurectomía.