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Endometriosis presenting as catamenial pneumothorax, pneumopericardium and pneumoperitoneum.

BMJ Case Rep

January 2025

Pulmonary Medicine, K S Hegde Medical Academy, Mangaluru, Karnataka, India

A nulliparous woman in her late 30s with a history of pericardial patch repair for atrial septal defect and completed treatment for pulmonary tuberculosis 9 years ago presented with chest pain, breathlessness and abdominal pain. Radiological imaging revealed right-sided pneumothorax, pneumopericardium and pneumoperitoneum for which an intercostal drain (ICD) was placed. A contrast-enhanced CT of the abdomen showed a distal stomach perforation, which was managed conservatively.

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Endometriosis is characterized by the ectopic implantation of a functional uterine lining outside of the uterus. Commonly, it occurs in the fallopian tubes, ovaries, uterosacral ligaments, and gastrointestinal tract. Less commonly, it may occur in the pericardium, pleura, and central nervous system.

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The Combined Robotic-assisted Laparoscopic and Thoracic Approach in the Management of Diaphragmatic, Pleural, and Pericardial Endometriosis.

J Minim Invasive Gynecol

July 2023

Center for Endometriosis and Minimally Invasive Gynecology (CEMIG London) (all authors), HCA The Lister Hospital, London, United Kingdom. Electronic address:

Study Objective: To demonstrate the advantages of a combined robotic-assisted laparoscopic and thoracic approach in the management of extensive diaphragmatic, pleural, and pericardial endometriosis.

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Endometriosis is a chronic disease, in which endometrial-like tissue is found outside the uterine cavity. Lesions are typically located in the true pelvis but can be found, in addition to extragenital endometriosis, in the respiratory system, the diaphragm, the pleura or the pericardium. As the extrauterine endometrial lesions undergo the menstrual cycle, they cause many symptoms, including pain, and besides infertility, they all mostly affect the quality of the patient's life.

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