Menstrual cycle related pneumothorax: case report and review of the literature

  • Nika Oreskovic MD.
  • Zeljko Djakovic Jordanovac Department of Thoracic Surgery, Zagreb University Hospital Centre, Jordanovac 104, Zagreb, Croatia
  • Ivka Djakovic Clinical Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Vinogradska 29, Zagreb, Croatia
  • Krunoslav Kuna Clinical Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Vinogradska 29, Zagreb, Croatia
Keywords: catamenial pneumothorax, video-assisted thoracic surgery, pelvic endometriosis, thoracic syndrome


Background: Catamenial pneumothorax is the most common form of thoracic endometriosis syndrome. It occurs around the beginning of a menstrual cycle. Although the mechanism of catamenial pneumothorax is not definitely clear, endometriosis plays an important role in it. Video-assisted thoracic surgery is standard procedure for the treatment of recurrent pneumothorax in general.

Case study: We report on a case of catamenial pneumothorax in women with a history of recurring spontaneous pneumotoraces associated with diaphragmatic endometrial implants who is involved in the IVF procedure.

Conclusion: Combination of video-assisted thoracoscopic surgery (VATS) and gonadotropinreleasing-hormone analogue gives the best results, to reduce the risk of pneumothorax to recur. Treatment of catamenial pneumothorax is complex and should include thoracic surgeon and gynecologist as soon as the diagnosis is definitive.


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Aissa S, Benzarti W, Alimi F, Gargouri I, Salem HB, Aissa A et al. Catamenial pneumothorax revealing diaphragmatic endometriosis: a case report and revue of literature. Pan Afr Med J. 2017 14; 27: 112.

Marjański T, Sowa K, Czapla A and Rzyman W. Catamenial pneumothorax – a review of the literature. Kardiochir Torakochirurgia Pol. 2016 13(2): 117–121.

Mehta CK, Stanifer BP, Fore-Kosterski S, Gillespie C, Yeldandi A, Meyerson S et al. Primary Spontaneous Pneumothorax in Menstruating Women Has High Recurrence. Ann Thorac Surg. 2016;102(4):1125-30.

Barbosa BC, Marchiori E, Zanetti GMR, and Barillo JG. Catamenial pneumothorax. Radiol Bras. 2015; 48(2): 128–9.

Visouli A, Zarogoulidis K, Kougioumtzi I, Huang H, Li O, Dryllis G et al. Catamenial pneumothorax. J Thorac Dis. 2014; 6(Suppl 4): S448–S460.

Kolos A, Dzhieshev Z, Dikolaev V, Amangaliev A. Catamenial Pneumothorax- poster presentation. Exp Clin Transplant. 2015;13 Suppl 3:144-5.

Takahashi R, Kurihara M, Mizobuchi T, Ebana H and Yamanaka S. Left-Sided Catamenial Pneumothorax with Thoracic Endometriosis and Bullae in the Alveolar Wall. Ann Thorac Cardiovasc Surg. 2017; 23(2): 108–112.

Fukuoka M, Kurihara M, Haga T, Ebana H, Kataoka H, Mizobuchi T. Clinical characteristics of catamenial and non-catamenial thoracic endometriosis related pneumothorax. Respirology 2015;20(8):1272-6

Korom S, Canyurt H, Missbach A, Schneiter D, Kurrer MO, Haller U. Catamenial pneumothorax revisited: clinical approach and systematic review of the literature J Thorac Cardiovasc Surg. 2004;128(4):502-8

Rousset-Jablonski C, Alifano M, Plu-Bureau G, Camilleri-Broet S, Rousset P, Regnard JF et al. Catamenial pneumothorax and endometriosis-related pneumothorax: clinical features and risk factors. Human Reproduction. Vol:26, No:9, 2011.

Ouede R, Alexandre BD, Gregoire AK, Kohou-Kone L, N'guessan E, Kouacou MG et al. Pneumothorax catamenial: results of 18 cases operas. Pan Afr Med J. 2018 25;30:168.

Ottolina J, De Stefano F, Vigano P, Ciriaco P, Zannini P, Candiani M. Thoracic Endometriosis Syndrome: Association With Pelvic Endometriosis and Fertility Status. J Minim Invasive Gynecol. 2017;24(3):461-5.

Bricelj K, Srpčič M, Ražem A, Snoj Ž. Catamenial pneumothorax since introduction of video-assisted thoracoscopic surgery: A systematic review. Wien Klin Wochenschr. 2017;129(19-20):717-26.

Mehedintu C, Plotogea MN, Ionescu S, Antonovici M. Endometriosis still a challenge. J Med Life. 2014 15;7(3):349-57.

Shikino K, Ohira Y, Ikusaka M. Catamenial pneumothorax. J Gen Intern Med. 2016;31(10):1260.

Alifano M, Roth T, Broet SC, Schussler O, Magdeleinat P, Regnard JF. Catamenial pneumothorax: a prospective study. Chest. 2003;124(3):1004-8.

Goorsenberg AWM, Pruis M, Boshuizen RC, Hindori V, Slaar A, Bresser P. Catameniale pneumothorax [Catamenial pneumothorax: an intriguing cause of recurrent pneumothorax in women]. Ned Tijdschr Geneeskd. 2018;162:D2340.

Tulandi T, Sirois C, Sabban H, Cohen A, Murji A, Singh SS et al. Relationship between Catamenial Pneumothorax or Non-catamenial Pneumothorax and Endometriosis. J Minim Invasive Gynecol. 2018;25(3):480-3.

Attaran S, Bille A, Karenovics W, et al. Videothoracoscopic repair of diaphragm and pleurectomy/abrasion in patients with catamenial pneumothorax: a 9-year experience. Chest. 2013;143:1066–9.

Baisi A, Raveglia F, De Simone M, Cioffi U. Catamenial Pneumothorax: A Matter of Anamnesis.Ann Thorac Surg. 2017 ;104(1):367-68.

Bagan P, Berna P, Assouad J, et al. Value of cancer antigen 125 for diagnosis of pleural endometriosis in females with recurrent pneumothorax. Eur Respir J. 2008;31:140–2.

Costa F, Matos F. Endometriose toracica. Rev Port Pneumol. 2008;XIV:427–35.

Cassina PC, Hauser M, Kacl G, et al. Catamenial hemoptysis. Diagnosis with MRI. Chest. 1997;111:1447–50.

Garner M, Ahmed E, Gatiss S, West D. Hormonal manipulation after surgery for catamenial pneumothorax. Interact Cardiovasc Thorac Surg. 2018 1;26(2):319-322.

Inam H, Inam S, Tahir M. Catamenial pneumothorax: A case report. J Pak Med Assoc. 2016;66(10):1327-1329.

Lalani S, Black A, Hodge MC, Tulandi T, Chen I. Dienogest Therapy as a Treatment for Catamenial Pneumothorax: Case Report and Review of Hormonal Options. J Obstet Gynaecol Can. 2017;39(9):764-768.

How to Cite
Oreskovic N, Djakovic Z, Djakovic I, Kuna K. Menstrual cycle related pneumothorax: case report and review of the literature. Acta Chir. Croat. [Internet]. 2020Oct.4 [cited 2020Oct.22];17(1):27-0. Available from:
Case Reports