Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with recurrent spontaneous pneumothorax occurring within 72 hours of the onset of menses. Symptoms include acute onset of pleuritic chest pain, dyspnea, and non-productive cough. History is significant for cyclical symptoms correlating with menstrual cycle. No history of trauma or underlying chronic obstructive pulmonary disease.
Clinical Examination Findings
Physical exam reveals diminished breath sounds on the affected side (typically right-sided). Percussion demonstrates hyper-resonance. Vital signs may show tachypnea and tachycardia. Pelvic examination may be indicated to evaluate for concurrent endometriosis.
Treatment Protocol
Initial management includes supplemental oxygen and needle aspiration or chest tube thoracostomy for lung re-expansion. Long-term management involves hormonal suppression (e.g., GnRH agonists or oral contraceptives) to inhibit ovulation. Surgical intervention via video-assisted thoracoscopic surgery (VATS) for pleurodesis and resection of diaphragmatic endometrial implants is recommended for recurrent cases.