Pneumoperitoneum associated with catamenial pneumothorax in women with thoracic endometriosis.

OBJECTIVE

To elucidate the pathophysiology of catamenial pneumothorax (CP) due to thoracic endometriosis and support the theory of the transdiaphragmatic passage of air from the genital tract through diaphragmatic perforations caused by endometrial implants.

DESIGN

Three case reports.

SETTING

Academic hospital.

PATIENT(S): Three women with pneumoperitoneum concomitant to CP.

INTERVENTION(S): Thoracic/abdominal computed tomography scans and chest x-rays.

MAIN OUTCOME MEASURE(S): Presence of pneumoperitoneum coexisting with CP.

RESULT(S): The observation of pneumoperitoneum associated with CP supports the theory of the transdiaphragmatic passage of air, which implies the occurrence of a pneumoperitoneum as an intermediate step.

CONCLUSION(S): Our three cases strongly support the theory of the transdiaphragmatic passage of air in the pathogenesis of CP.