Kumakiri Jun, Takeuchi Hiroyuki, Miyamoto Hideaki, Shimanuki Hiroto, Kobayashi Yuko, Kuroda Keiji
Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan.
Fertil Steril. 2008 Oct;90(4):1200.e11-4. doi: 10.1016/j.fertnstert.2007.09.023. Epub 2007 Dec 26.
To explore diaphragmatic lesions that are potentially associated with catamenial pneumothorax by using an advanced flexible laparoscope with wide optic angle.
Case report.
University hospital.
PATIENT(S): A 30-year-old woman who was scheduled for thoracoscopic surgery because of recurrent right-sided catamenial pneumothorax.
INTERVENTION(S): The peritoneal surface of the diaphragm was explored with an advanced flexible laparoscope that was equipped with a charge-coupled device on the tip, concurrently with thoracoscopic surgery.
MAIN OUTCOME MEASURE(S): Lesions associated with endometriosis on the peritoneal surface of the posterior diaphragm abutting the posterior abdominal wall and liver.
RESULT(S): When the flexible laparoscope was inserted via an umbilical trocar and the peritoneal surface of the right-sided diaphragm was explored, guided by illumination from the thoracoscope, scattered specific lattice lesions and fenestrations were identified in the central tendon of the posterior diaphragm, a region that cannot be visualized with the conventional rigid laparoscope.
CONCLUSION(S): By using the flexible laparoscope, endometriotic lesions potentially related to catamenial pneumothorax were identified on the posterior diaphragm.
使用具有广角视野的先进软性腹腔镜，探索与月经期气胸可能相关的膈肌病变。
病例报告。
大学医院。
一名30岁女性，因复发性右侧月经期气胸计划接受胸腔镜手术。
在胸腔镜手术的同时，使用尖端配备电荷耦合装置的先进软性腹腔镜探查膈肌的腹膜表面。
与后腹壁和肝脏相邻的后膈肌腹膜表面与子宫内膜异位症相关的病变。
当通过脐部套管插入软性腹腔镜并在胸腔镜照明引导下探查右侧膈肌的腹膜表面时，在后膈肌中央腱中发现了散在的特定格子状病变和小孔，这是传统硬性腹腔镜无法观察到的区域。
通过使用软性腹腔镜，在后膈肌上发现了可能与月经期气胸相关的子宫内膜异位症病变。
