SHM Converge Scientific Abstract ePoster Gallery-An Unusual Case of Recurrent Catamenial Hydropneumothorax in a 33-Year-Old Female

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This case report describes a 33-year-old woman with recurrent catamenial hydropneumothorax due to thoracic endometriosis. Catamenial pneumothorax is a rare form of recurrent pneumothorax that occurs within about 72 hours of menstruation onset and accounts for an estimated 3–6% of spontaneous pneumothoraces in menstruating women. It most often affects the right side and is the most common manifestation of thoracic endometriosis syndrome.<br /><br />The patient had a history of endometriosis and had recently been treated at an outside hospital for a right pneumothorax with pleural effusion. Thoracoscopy there revealed diaphragmatic fenestrations and endometrial implants. She underwent partial pleurectomy, pleurodesis, and repair of diaphragmatic defects, and pathology confirmed endometriosis in the pleura and diaphragm. Because GnRH agonist therapy such as leuprolide was unaffordable, she was given depot-medroxyprogesterone acetate for hormonal suppression.<br /><br />Despite these interventions, she returned one week later with worsening shortness of breath and lightheadedness. Imaging showed a large right hydropneumothorax. Initial chest tube management failed, first due to tube malfunction and then because the pneumothorax enlarged despite replacement. She ultimately required repeat right thoracoscopy with right middle lobe web resection, partial pleurectomy, pleurodesis, and partial decortication. She was discharged on room air with hormonal contraception to suppress ovulation.<br /><br />The case highlights that catamenial pneumothorax should be considered in reproductive-age women with recurrent spontaneous pneumothorax. It also emphasizes that even with combined surgical and hormonal treatment, recurrence remains common and the underlying cause is not fully understood.

Asset Subtitle

Elizabeth Harris

Meta Tag

Author List Elizabeth Harris, Rogelio Schouten-Hernandez

Category Clinical Vignettes

Concept Thoracic Endometriosis

Concept Catamenial Pneumothorax

Concept Recurrent Spontaneous Pneumothorax

Concept Recurrence Risk

Concept Menstruation

Distinguished Non-Finalist

Presenter Organization UT Southwestern Medical Center

Presenting Author Elizabeth Harris

Track Adult

Keywords

catamenial pneumothorax

thoracic endometriosis

hydropneumothorax

recurrent pneumothorax

endometriosis

thoracoscopy

pleurodesis

diaphragmatic fenestrations

hormonal suppression

right-sided pneumothorax

Thoracic Endometriosis

Catamenial Pneumothorax

Recurrent Spontaneous Pneumothorax

Recurrence Risk

Menstruation