CATAMENIAL PNEUMOTHORAX: PRESENTATION OF A CASE AND REVIEW OF THE LITERATURE

Endometriosis is dened as the presence of functional extra-uterine endometrial tissue, which can suffer hemorrhage, inammation, brosis and adhesion formation, causing pelvic pain and infertility. The chest is a place where the presentation of endometriosis is rare, its diagnosis is based on the clinical picture of pneumothorax without associated trauma but with cyclical presentation. The pathological study is based on the presence of stroma and endometrial glands. The management of thoracic endometriosis is medical based on hormonal treatment, and surgical management for the management of complications or resection of the ovaries and hysterectomy to avoid recurrence. We present a case of a patient with recurrent catamenial pneumothorax.

Extragenital endometriosis as a cause of catamenial pneumothorax in women: own experience

Introduction. Catamenial pneumothorax is one of the most difficult to diagnose types of spontaneous pneumothorax in women. The cause of the latter is ectragenital localization of endometriosis. To date, there is no clear pathogenetically determined treatment and treatment algorithm for the management of this category of patients. Objective: to analyze and structure our own experience in the treatment of catamenial pneumothorax. Materials and methods. For the period 2011–2020 in the Thoracoabdominal Department of the SI "Zaytcev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine" 7 women with catamenial pneumothorax were on inpatient treatment. Results. After additional examination, all patients underwent draining of the pleural cavity with Bulau as the first stage after the diagnosis was established. At the second stage, all patients underwent minimally invasive surgical interventions – videothoracoscopic resection of the endometriosis-affected areas of the costal parietal pleura and diaphragm, mechanical pleurarasion and pleurodesis, using fibrin-collagen plates in the areas of diaphragm defects. There were no postoperative complications or deaths. Conclusion. In the treatment of extragenital endometriosis complicated by catamenial pneumothorax, not only thoracic surgeons, but also obstetrician-gynecologists should take part in order to create multidisciplinary commissions aimed primarily at determining the pathogenetically determined treatment tactics. Key words: extragenital endometriosis, catamenial pneumothorax, videothoracoscopy, surgical treatment.