Abstract
A 37-year-old female, with a history of three previous episodes of right pneumothorax, visited our hospital with the chief complaint of a feeling of oppression of the right chest. Her chest X-ray film on admission revealed mild right pneumothorax. During the most recent previous episode, thoracoscopy at another hospital had shown no evidence of bullae or blebs, so pleurodesis was performed. Recurring right pneumothorax had been strongly suspected of being associated with menstruation in all of episodes. So cat menial pneumothorax was diagnosed. A large amount of air (about 500 ml) was insufflated through the uterus and Fallopian tubes, and two hours later her chest X-ray film showed free air below both diaphragms and aggravation of the right pneumothorax. Therefore, we performed surgery with confidence in our diagnosis. Since many small holes were observed in the center of the diaphragm, the region was resected and the defect sutured. The resected specimen showed no pathological evidence of endometriosis. At present, four months after the operation, no recurrence of pneumothorax can be seen.
In comparison with the conventional technique, pneumoperitoneum, transhysterosalpingial insufflation is a non-surgical, simple and very useful diagnostic method. Our technique confirmed the theoretical basis of this disease and demonstrated its pathogenesis.
