SHM Converge Scientific Abstract ePoster Gallery-Recurrent Spontanous Pneumothorax: A Cyclical Conundrum

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A 26-year-old woman with endometriosis and recurrent tubo-ovarian abscesses had three episodes of right-sided pneumothorax over several years. Her first pneumothorax in 2017 resolved spontaneously. A second episode in 2020 was treated with video-assisted thoracoscopic surgery (VATS), apical blebectomy, and mechanical pleurodesis; pathology showed benign lung tissue without evidence of thoracic endometriosis. Despite surgery, she developed another right-sided pneumothorax in 2021.<br /><br />Because several episodes appeared to occur around her menstrual cycle, and given her history of endometriosis with no other clear cause, clinicians diagnosed catamenial pneumothorax rather than simple spontaneous pneumothorax. Catamenial pneumothorax is often missed because its timing relative to menstruation can be variable and is not always obvious. It typically occurs in women of reproductive age, often within 72 hours of menses, but there is wide overlap and inconsistency in presentation.<br /><br />The underlying cause is not always identified, though pelvic or thoracic endometrial implants are common. These lesions may be missed during evaluation, especially in the tendinous portion of the diaphragm. Because recurrence after surgery is common, reported in about 30–40% of cases, the patient was started on hormonal therapy after her third episode. Since then, she has not had any further recurrences.<br /><br />The case highlights the importance of considering catamenial pneumothorax in reproductive-age women with recurrent pneumothorax, particularly when episodes relate to the menstrual cycle. Diagnosis and management should involve a multidisciplinary team including primary care, pulmonology, gynecology, and surgery. Adjuvant hormonal suppression, such as contraceptives or GnRH agonists, can reduce recurrence after surgical treatment.

Asset Subtitle

Ritika Gadodia

Meta Tag

Author List Breanna Goldner, Christian J. Woods, Rea Pavate, Reema Rani, Ritika Gadodia

Category Clinical Vignettes

Concept Catamenial Pneumothorax

Concept Recurrent Pneumothorax

Concept Menstruation

Concept Reproductive-Age Women

Concept Primary Spontaneous Pneumothorax

Distinguished Non-Finalist

Presenter Organization Medstar Washington Hospital Center

Presenting Author Ritika Gadodia

Track Adult

Keywords

catamenial pneumothorax

recurrent pneumothorax

endometriosis

thoracoscopic surgery

pleurodesis

thoracic endometriosis

menstrual cycle

hormonal therapy

diaphragmatic implants

reproductive-age women

Catamenial Pneumothorax

Recurrent Pneumothorax

Menstruation

Reproductive-Age Women

Primary Spontaneous Pneumothorax