A 35 years old female having a lung rupture because of menstruation...

I got an emergency call from the Emergency room

" Doc , we got a case of chest pain upon breathing .. looks agitated ... please come now !! "

After complete history, physical examination and initial stabilization, Chest X ray was requested ... and there we got another such case ..

In the last 2 month, this is my 3rd case of CATAMANEAL PNEUMOTHORAX

Spontaneous Lungs Rupture ( Pneumothorax ) during mensturation...

The black shaded area show air leakage into the chest cavity

What is it ..?

- This is called Catamaneal Pnuemothorax. A condition with abnormal growth of uterus cells in the lung. So, when there is a menstruation, these cells in the lung perforate and menstruate in the lung cavity. Thus, leads to air leakage into chest cavity.

What is the concern ?

- Well, there is a potential of life threatening heart arrest if the air accumulate in the chest cavity in excess and further compress the lung and heart (Tension Pneumothorax)

Is it serious/ Dangerous Always ?

- Not Always. There are mild to severe forms of rupture.

The leakage air in the close chest cavity starts to compress the lung. More the leakage, more the compression. Excess air can compress the heart and cause immediate heart arrest.

Is it Curable ?

- It is PREVENTABLE. Patients will have to be on oral contraceptives to inhibit menstruation. This will stop cells from proliferating and rupture.

Contraception in any form : oral , injection , implant etc.

What are the Treatments ( briefly) ?

- Treatment is divided into 2 phase

Emergent Phase : Stabilize patient, maintain Oxygenation, Needle Tap of the Lung OR insertion of chest drain to evacuate the air ( depends on many factor)

Long Term Phase : prevent menstruation. CT chest in case of suspecting other confounding disease.

This patient , fortunately, resolved with only oxygen therapy. Now she is on oral contraceptive pills. Her CT chest did not show any other disease. She is back to her daily routine.

Take Home Message : Painful or Difficult Breathing During Menstruation may need medical attention.