Catamenial pneumothorax: case report and literature review

Since the initial case report in 1958, 69 cases of catamenial pneumothorax have appeared in English-language literature. Despite the extensive case material, the pathogenesis has not been fully elucidated. Herein an additional case is reported utilizing computed tomography (CT) to search for intrathoracic endometrial implants. The four major pathogenetic theories include passage of air from the genital tract via diaphragmatic defects, spontaneous rupture of subpleural blebs, intrathoracic endometriosis, and prostaglandin-induced bronchiolar constriction resulting in alveolar rupture. Evidence for and against each theory is presented.