Preventing Recurrence: Optimal Surgical and Medical Management of Catamenial Pneumothorax

The authors describe the successful surgical and medical
management of a young woman with recurrent catamenial pneumothoraxes. A 34-year-old
woman was referred to thoracic surgery clinic for recurrent episodes of
dyspnea. She stopped taking oral contraceptive pills at the age of 30, shortly
after which she began having recurrent episodes of dyspnea, cough, and
dysmenorrhea. She underwent a diagnostic laparoscopy with evidence of pelvic
endometriosis. She was found to have a right pneumothorax and had a chest tube
placed. The pneumothorax persisted and she underwent a VATS blebectomy and
decortication at an outside hospital.
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Images:

Figure 1. Selected
images of the patient’s preoperative computed tomography imaging showing her
right apical and basilar pneumothoraxes and pigtail thoracostomy tube.

Figure 2. The
patient’s 14-month postoperative chest x-ray showing no recurrence of her
pneumothorax.