Actualización del diagnóstico y manejo del neumotórax catamenial asociado al síndrome de endometriosis torácica

Abstract

Introduction: Catamenial pneumothorax (CP), is the most frequent clinical presentation of thoracic endometriosis syndrome (SET), which is characterized by recurrent primary spontaneous pneumothorax in association with menstruation and the presence of endometrial tissue in the lungs and pleura. Objective: To describe the diagnosis and management of catamenial pneumothorax associated with thoracic endometriosis syndrome. Methods: A literature search was performed using PubMed, Nature, Science Direct, Scielo, Cochrane, The Lancet, The New England Journal of Medicine databases on "thoracic endometriosis syndrome", "catamenial pneumothorax" and "spontaneous pneumothorax". Results: We found 60 bibliographic sources related to CP published in the last 5 years, from which 31 were selected considering the inclusion and exclusion criteria. Discussion: CP most frequently affects women with an average age of 34 to 37 years, whose incidence can reach 41% of all pneumothoraces. The most accepted explanation is the retrograde menstruation theory, affecting more frequently the right hemithorax with 73%. The most predominant symptoms are dyspnea, pleuritic pain, cough and it is often related to dysmenorrhea and infertility. Diagnosis is made by clinical history, imaging and cytological tests. Conclusions: Currently video-assisted thoracoscopic surgery (VATS) is the best option for diagnosis and treatment which in conjunction with hormonal therapy prevents recurrences.