横隔膜縫縮術のみを施行した月経随伴性気胸

Thoracoscopic Diaphragmatic Stitching for the Catamenial Pneumothorax

月経随伴性気胸は月経周期に一致して気胸を繰り返す疾患であり，その発生機序や治療法にはいまだ一定の見解がない．われわれは，横隔膜にblueberry spotを認めた中年女性の月経随伴性気胸に対して，胸腔鏡下に横隔膜縫縮術のみを施行した1例を経験したので，文献的考察を加えて報告する．

A 46-year-old woman experienced an initial episode of right-sided spontaneous pneumothorax at the time of menstruation. The findings of thoracoscopic examination suggested catamenial pneumothorax. Thoracoscopic surgery revealed multiple blueberry spots on the diaphragm. Considering the patient to be premenopausal within several years and expecting postoperative hormonal therapy, we stitched all lesions without resection for detailed histopathological diagnosis. The patient is well 5 months postoperatively.