Catamenial Pneumothorax: Report of a Case

月經性氣胸：病例報告

吳南鈞(Nan-Chun Wu) ； 錢尚道(Shang-Tao Chien) ； 許正義(Jane-Yi Hsu)

《Formosan Journal of Surgery》 38卷5期 (2005/10) Pp. 256-260

https://doi.org/10.29833/FJS.200510.0008

摘要

月經性氣胸是一種罕見的疾病。從1958年以來，世界上總共只有報告過兩百多個病例。雖然有很多病因被提出來討論，但是真正的原因仍然不清楚。我們報告一個37歲的女性，沒有抽煙的個人史，因為在月經來的第二天被發現一個復發的右側自發性氣胸而入院。胸部電腦斷層掃瞄並未發現任何除了氣胸以外的異常。以胸腔鏡檢查時，發現在右側橫膈膜的中央韌帶部位有許多大小不一的孔洞。顯微鏡下發現有一層中皮細胞覆蓋在所有的孔洞周圍，並沒有發現任何子宮內膜異位的腺體組織。在我們的報告中，我們將會敘述與討論各種不同病因的假說。至於如何治療月經性氣胸，仍然是眾說紛紜，包括手術治療、胸管放置、荷爾蒙治療，甚至輸卵管結紮等等，而手術治療與術後合併使用荷爾蒙抑制排卵及子宮內膜的活性仍然是所有文獻報告中最為有效的治療方式。

並列摘要

Catamenial pneumothorax is a rare disease, with only over two hundred cases reported since 1958. Its exact cause is still unknown, though many etiologies have postulated. We present a 37-year-old non-smoking female whose menstruation was concurrent with recurrent right-sided spontaneous pneumothorax. Computed-tomography of the chest showed right-sided pneumothorax. At thoracoscopy, multiple fenestrations were revealed on the tendinous part of the right hemidiaphragm. They were resected and repaired for pathological studies. Microscopic findings revealed mesothelial cells lining around the fenestrations. No endometrial gland was found. We will describe and discuss the hypotheses of etiologies in our report. The treatment of catamenial pneumothorax is controversial, including surgery, tube thoracotomy, fallopian tube ligation and hormonal therapy. Surgical intervention together with hormonal therapy remains the most effective way and conforms to the principle of treatment.

並列關鍵字

catamenial pneumothorax ； endometriosis