Extraperitoneal endometriosis with catamenial pneumothoraces: a review of the literature

JSLS. 2003 Oct-Dec;7(4):371-5.


Objective: To present a case of recurrent catamenial pneumothorax and diaphragmatic endometriosis that was managed thoracoscopically. A review of the literature is also presented.

Methods: A-28-year-old woman presented with bloody stools, chronic constipation, and chest pain. A review of systems was positive for monthly chest pain associated with her menses. A preoperative chest x-ray revealed a right pneumothorax. Colonoscopy revealed biopsy proven endometriosis of the sigmoid colon. A pelvic computed tomography scan revealed bilateral complex, cystic and solid adenexal lesions.

Results: A right thoracoscopy was performed. A lesion on the right hemidiaphragm was excised and confirmed to be endometriosis. A wedge section of lung tissue containing a bleb was resected and also contained endometriosis. Three months later, the patient underwent laparoscopic excision of her pelvic endometriosis, including a low anterior rectal resection. Five months later, she presented again with right-sided chest pain. A thoracoscopic right total pleurectomy was performed for recurrent pneumothorax.

Conclusion: Pullmonary endometriosis may present as chest pain, shortness of breath, or hemoptysis associated with menstrual cycles. This case emphasizes the importance of a careful review of systems in patients with known endometriosis. Management now includes an endoscopic alternative and all of its known benefits.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Diaphragm
  • Digestive System Diseases / diagnosis
  • Digestive System Diseases / surgery
  • Endometriosis / diagnosis*
  • Endometriosis / surgery*
  • Female
  • Humans
  • Pneumothorax / diagnostic imaging
  • Pneumothorax / surgery*
  • Radiography
  • Recurrence
  • Sigmoid Diseases / diagnosis
  • Sigmoid Diseases / surgery*
  • Thoracoscopy / methods*
  • Treatment Outcome