{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:59:31Z","timestamp":1792501171086,"version":"4.5.0"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T00:00:00Z","timestamp":1618876800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T00:00:00Z","timestamp":1618876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Catamenial pneumothorax is characterized by spontaneous recurring pneumothorax during menstruation, which is a common clinical manifestation of thoracic endometriosis syndrome. There are still controversies about its pathogenesis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 43-year-old woman with a history of endometriosis came to our hospital due to recurring pneumothorax during menstruation. Uniportal Video-assisted Thoracoscopic Surgery (VATS) exploration was performed on the eve of menstruating. We thoroughly explored the diaphragm, visceral and parietal pleura: The lung surface was scattered with yellowish-brown implants; no bullae were found; multiple diaphragmatic defects were found on the dome. And surprisingly, we caught a fascinating phenomenon: Bubbles were slipping into pleural cavity through diaphragmatic defects. We excised the diaphragmatic lesions and wedge resected the right upper lung lesion; cleared the deposits and flushed the thoracic cavity with pure iodophor. Diaphragmatic lesions confirmed the presence of endometriosis, and interestingly enough, microscopically, endometrial cells were shedding with impending menses. After a series of intraoperative operations and postoperative endocrine therapy, the disease did not recur after a period of follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We have witnessed the typical signs of catamenial pneumothorax at the accurate timing: Not only observed the process of gas migration macroscopically, but also obtained pathological evidence of diaphragmatic periodic perforation microscopically, which is especially precious and confirms the existing theory that retrograde menstruation leads to diaphragmatic endometriosis, and the diaphragmatic fenestration is obtained due to the periodic activities of ectopic endometrium.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12905-021-01318-0","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T12:21:36Z","timestamp":1618921296000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report"],"prefix":"10.1186","volume":"21","author":[{"given":"Bo","family":"Dong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Li","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin-liang","family":"Sheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guan-Chao","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Fei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Hao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8755-4238","authenticated-orcid":false,"given":"Yu","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,20]]},"reference":[{"issue":"15","key":"1318_CR1","doi-asserted-by":"publisher","first-page":"2013","DOI":"10.1001\/jama.1958.63000150008012c","volume":"168","author":"ER Maurer","year":"1958","unstructured":"Maurer ER, Schaal JA, Mendez FL. Chronic recurring spontaneous pneumothorax due to endometriosis of the diaphragm. J Am Med Assoc. 1958;168(15):2013\u20134.","journal-title":"J Am Med Assoc"},{"issue":"10","key":"1318_CR2","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1001\/jama.1972.03190360038009","volume":"219","author":"GA Lillington","year":"1972","unstructured":"Lillington GA, Mitchell S. Catamenial pneumothorax. JAMA. 1972;219(10):1328\u201332.","journal-title":"JAMA"},{"issue":"6","key":"1318_CR3","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.jfma.2011.04.006","volume":"113","author":"L Baoquan","year":"2014","unstructured":"Baoquan L, Liangjian Z, Qiang W, Hai J, Hezhon C, Zhiyun X. Catamenial pneumothorax associated with multiple diaphragmatic perforations and pneumoperitoneum in a reproductive woman. J Formos Med Assoc. 2014;113(6):385\u20137.","journal-title":"J Formos Med Assoc"},{"key":"1318_CR4","doi-asserted-by":"crossref","unstructured":"Hsu PK. Tissue graft to cover diaphragmatic defects in a patient with catamenial pneumothorax. Ann Thorac Surg. 2019; 107(e143).","DOI":"10.1016\/j.athoracsur.2018.07.087"},{"issue":"2","key":"1318_CR5","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1016\/S0003-4975(02)03702-5","volume":"74","author":"T Roth","year":"2002","unstructured":"Roth T, Alifano M, Schussler O, Magdaleinat P, Regnard JF. Catamenial pneumothorax: chest X-ray sign and thoracoscopic treatment. Ann Thorac Surg. 2002;74(2):563\u20135.","journal-title":"Ann Thorac Surg"},{"issue":"3","key":"1318_CR6","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1016\/j.athoracsur.2014.05.056","volume":"99","author":"Y Kawaguchi","year":"2015","unstructured":"Kawaguchi Y, Fujita T, Hanaoka J. Catamenial pneumothorax with bullae. Ann Thorac Surg. 2015;99(3):1075\u20138.","journal-title":"Ann Thorac Surg"},{"issue":"1","key":"1318_CR7","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.jtcvs.2012.08.054","volume":"145","author":"M Takahashi","year":"2013","unstructured":"Takahashi M, Matsukura T, Hirai T, Mino N. Recurrent catamenial hemopneumothorax treated by coverage with polyglycolic acid sheets. J Thorac Cardiovasc Surg. 2013;145(1):300\u20132.","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"6","key":"1318_CR8","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.jfma.2011.04.006","volume":"113","author":"L Baoquan","year":"2014","unstructured":"Baoquan L, Liangjian Z, Qiang W, Hai J, Hezhong C, Zhiyun X. Catamenial pneumothorax associated with multiple diaphragmatic perforations and pneumoperitoneum in a reproductive woman. J Formos Med Assoc. 2014;113(6):385\u20137.","journal-title":"J Formos Med Assoc"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-021-01318-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12905-021-01318-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-021-01318-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T12:22:56Z","timestamp":1618921376000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcwomenshealth.biomedcentral.com\/articles\/10.1186\/s12905-021-01318-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,20]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1318"],"URL":"https:\/\/doi.org\/10.1186\/s12905-021-01318-0","relation":{},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,20]]},"assertion":[{"value":"9 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was given by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"For publication of this case report, including the images contained within, informed written consent was obtained from the patient. A copy of the consent form is available for review by the Editor of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"167"}}