Pneumothorax Cataménial mpi Endometriose Thoracique: Kubwa ya Pulmon ya Luse ya Diboko ya Kitata yina Kevutukilaka Na Nsungi ya Bangunga 72 ya Kumona Ngonda mpi ya Kusala Bafenetre ya Diaphragme¶

Kana nkento yina kele na mvula ya kubuta kewa mpasi ya ngolo na ntulu, mpasi na mapeka, mpi kukonda mpema na kintulumukina yina kesimbaka yandi mbala na mbala na bangunga 24 na ntwala tii na bangunga 72 na nima ya luyantiku ya ntangu na yandi ya kumona ngonda, kikuma na yo kevandaka mbala mingi Catamenial comPneumothorax cliniquetheThorax most Kimbevo kia ntu (TES). Na kutadila tii na 25 tii na 35 na kati ya nkama ya ba pneumothorax yonso ya kukonda kukana na bankento yina bo ke tindaka sambu na kusala operasio ya thorax, pneumothorax cataménial ke zabanaka mingi ve sambu ba departema ya urgence ke tadilaka mbala na mbala konso episode bonso “pneumothorax ya kukonda kukana ya ntete” ya me katuka na bantu yina ke bela kukonda bonso’ kuking. Na kubulaka pumo ya diboko ya kitata na 85 tii na 95 na kati ya nkama ya bantu, pneumothorax cataménial kesalamaka ntangu bo ketulaka misisa ya endometrium na tendon ya kati-kati ya hémidiaphragme ya diboko ya kitata mpi na pleure viscérale yina kekutanaka ti kukonda ngolo ya hormone ya ketambulaka na nziunga na ntangu ya kumona ngonda, mpi yo kesalaka nde milli-diaphrame ya kufuluka fenestrations) na ntangu yina kufwanisa na mbala mosi ya bouchon ya mucus ya cervix kepesaka nzila na mupepe ya mupepe to na kupasuka ya alveole yina prostaglandine kesala sambu na kufwa bapumo. Na zulu ya mambu yina, endometriose thoracique lenda monana ti ba urgences tatu ya nkaka ya cyclique ya ntulu na ntangu ya kumona ngonda: hémothorax cataménial (kubasika menga mingi na kati ya dibulu ya pleura ya diboko ya kitata), hémoptyse cataméniale (kukosula menga ya mbwaki ya ngolo yina ke katukaka na nome-pulmonaire bronchique mpi**endometrise endometrique). Kana nge kewa mpasi ya ngolo na kintulumukina na ntulu yina kekuma dyaka ngolo kana nge kepema ngolo, nge kewa mpasi na nsuka ya dipeka ya diboko ya kitata yina nge lenda tendula ve, nge kekosula menga, nge kewa kizungu-zungu, to nge kepema nkufi na nziunga ya ntangu ya nge kemona menga, binga bantu ya bwala na beno . nimero ya urgence mbala mosi (911 na États-Unis mpi na Canada, 112 na Union Européenne ya mvimba, 999 na Royaume-Uni). Tadila mpi bantuma na beto ya banduku na . pneumothorax ya kukonda kukana mpi kigonsa ya kuvanda na zulu, pneumothorax ya tension mpi lusadisu ya ntete ya ntulu, mpidina kukosa menga (hemoptyse).

Kima ya nge fwete sala nswalu na ntangu ya maladi ya ngolo kele kukwenda na Departema ya Ke Talaka Mambu ya Lufwa ya Lupitalu sambu na kusala rayon X ya ntulu ya kusungama, ultrason ya bapumo, to CT ya ntulu, kubaka oxygène supplémentaire à haut-flux (yina ke salaka nde mupepe ya pleure kubaka diaka nswalu mbala iya) mpi **kukangama fioti kana yo kele mfunu mingi. kubwa kele nene to kele ti bidimbu, mpi zabisa na pwelele yonso munganga ya urgence mpi munganga ya ke salaka operasio ya ntulu nde bidimbu na nge me monana na nsungi ya bangunga 72 ya kubasika ya menga sambu bo tala tendon ya kati-kati ya diaphragme ya diboko ya kitata sambu na kuzaba kana yo kele ti bafenetre ya fromaze ya Suisse na ntangu ya Video-AssiscopicTSy coordinate kukanga ba hormone na nima ya kusala operasio (ba agoniste ya GnRH, ba progestine, to ba contraceptifs oraux continus) sambu na kubuyisa ntalu ya 30 tii na 50 na kati ya nkama ya kuvutukila maladi yina kemonanaka na nima ya kusala operasio ya bapumo mpamba.

Sala yo sesepi¶

1. Binga mbala mosi nimero ya urgence ya bwala na beno kana nge me mona mpasi ya ngolo ya kupema na kintulumukina, mpasi ya ngolo na ntulu, bibeku ya mbwaki, ntima ke bula ngolo kuluta 110 bpm, kizungu-zungu, to nge ke kosula menga. Binga 911 na États-Unis mpi na Canada, na 112 na Royaume-Uni, na Australie90 tala nzila na beto ya ntoto ya mvimba ya nimero ya urgence. Ata ba pneumothorax mingi ya cataménial kele ya fioti-fioti, kubwa ya nene to hémopneumothorax cataménial (kuvukisa mupepe ti menga na kifu) lenda kwenda na ntwala tii na physiologie ya tension yina ke tula luzingu na kigonsa to choc hémorragique.
2. Sit Upright in a Comfortable Slightly Forward-Leaning Position and Breathe Calmly. Avoid straining, coughing forcefully, holding your breath, or lifting anything heavy, as sudden spikes in intrathoracic pressure (Valsalva maneuver) force more air through the visceral pleural defect or diaphragmatic fenestrations into the pleural space.
3. Tubila Munganga ya Urgence Nswalu: "Nsungi na mono me yantika na bangunga 72 ya nsuka (to Yo fwete salama mbasi), pardo tala kana mono kele ti pneumothorax cataménial." Bambefo mingi yina kele ti pneumothorax cataménial ke kangaka ntima na **3 tii na 5 episode ya kukabwana ya candarne ya me bwa na ntwala ya babakala na bo Rapore ya sikisiki kana nge kele ti disolo ya endometriose ya divumu, ba mpasi ya ngolo ya kumona ngonda (dysménorrhée), kukonda kubuta, operation ya ntwala ya divumu, to mpasi ya cyclique na dipeka/ntulu ya diboko ya kitata na ntangu ya nge ke monaka menga ("mpasi ya endometriose diaphragmatique").
4. Request High-Flow Supplemental Oxygen in the Ambulance and Emergency Department. Breathing 100 percent oxygen through a non-rebreather mask washes nitrogen out of your bloodstream (the nitrogen washout effect), creating a steep diffusion gradient that speeds up the reabsorption of trapped pleural air from 1.25 percent per day to over 4 to 5 percent per day.
5. Do Not Fly in an Airplane or Scuba Dive Until a Chest X-Ray or CT Confirms Complete Resolution and You Are Cleared by a Thoracic Specialist. According to Boyle's Law, unvented air trapped in the pleural space expands by 25 to 35 percent at commercial aircraft cabin altitude (2,400 meters / 8,000 feet), which can convert a mild menstrual lung collapse into a fatal mid-flight tension pneumothorax.
6. If Referred for VATS Surgery After a Recurrent Right-Sided Collapse: Verify That the Thoracic Surgeon Inspects and Repairs the Diaphragm (Not Just the Lung Apex) and Coordinates Hormonal Therapy with a Gynecologist. Standard apical bleb stapling alone fails in up to 40 percent of women with catamenial pneumothorax unless the diaphragmatic fenestrations (holes) are closed/plicated with mesh and post-operative ovarian estrogen cycling is suppressed.

Clinical decision tree: evaluating menstrual-linked chest pain and lung collapse¶

flowchart TD
    A["Reproductive-age woman presents with acute pleuritic chest pain, dyspnea, right shoulder pain, or hemoptysis"] --> B{"Check Temporal Link to Menstrual Cycle: Did symptoms start within 24 hours BEFORE to 72 hours AFTER onset of menses?"}
    B -->|Yes: Cyclical synchronicity with menses (Catamenial window)| C["High Clinical Suspicion for Thoracic Endometriosis Syndrome (TES) / Catamenial Pneumothorax"]
    B -->|No clear menstrual link initially| D["Evaluate as Spontaneous Pneumothorax, Pulmonary Embolism, or Pleurisy; instruct patient to log future chest symptoms against a 3-month menstrual calendar"]
    C --> E["Emergency Department Workup: Upright Chest X-Ray, Bedside Lung Ultrasound (POCUS), and Chest CT; check Hemoglobin if pleural fluid/hemothorax present"]
    E --> F{"What specific Thoracic Endometriosis manifestation is identified on imaging?"}
    F -->|Pneumothorax (90% to 95% Right-Sided; 73% of all TES cases)| G["Catamenial Pneumothorax (CP): Administer high-flow 100% O2; insert small-bore 8F to 14F pigtail chest drain if collapse is over 2 cm at hilum or breathless"]
    F -->|Bloody Pleural Effusion (12% of TES cases; Right-Sided)| H["Catamenial Hemothorax: Insert 24F to 28F chest tube; check CBC/coagulation; restore blood volume; urgent Thoracic Surgery consult"]
    F -->|Coughing Up Bright Red Blood during menses (7% of TES) with parenchymal ground-glass opacity on CT| I["Hemoptise cataméniale: Kupesa muntu acide tranexamique (TXA) yina bo me tula na nitu; landa kubasisa menga na nsi; bronchoscopie sambu na kuzaba maladi mpi kukanga ba hormone"]
    G --> J["Kukangama ya ngolo na mitindu mingi (Kusala operasio ya thorax + Gynécologie): Kukatula ya wedge apical ya VATS ya kuvukisa + Kuyidika/Mesh ya fenestration ya diaphragme + Pleurodèse"]
    H --> J
    J --> K["Mandatory Post-Operative Hormonal Suppression for 6 to 12+ months (GnRH agonist with add-back therapy, Dienogest, or continuous progestin/OCP)"]

Pathophysiologie: Sambu na nki Endometriose Ke Kumaka na Ntulu mpi Sambu na Nki 90% ya Kubwa Ke Salamaka na Ndambu ya Diboko ya Kitata¶

Endometriosis is the presence of functional endometrial glands and stroma outside the uterine cavity, affecting approximately 10 percent of women of reproductive age. While most implants remain in the pelvis (ovaries, uterosacral ligaments, pouch of Douglas), endometrial cells can travel to the thoracic cavity, creating Thoracic Endometriosis Syndrome (TES). Four interconnected anatomical and physiological mechanisms explain how menstruation triggers a collapsed lung within 72 hours of menses onset:

1. Courant ya masa ya peritoneal na ndambu ya ntangu ("L'ascenseur peritoneal") mpi sambu na nki 90% kele na ndambu ya diboko ya kitata .¶

Why does catamenial pneumothorax strike the right lung in 85 to 95 percent of cases, the left lung in under 5 percent, and bilaterally in only 3 to 5 percent? The answer lies in peritoneal fluid circulation and abdominal ligament anatomy: - During retrograde menstruation, viable endometrial cells shed through the fallopian tubes into the pelvic peritoneal cavity. - Inside the abdomen, intestinal peristalsis and negative subdiaphragmatic respiratory pressure drive peritoneal fluid in a continuous clockwise circulation: fluid flows upward along the right paracolic gutter to the right subphrenic space directly underneath the right dome of the diaphragm. - On the left side, the phrenicocolic ligament (between the splenic flexure of the colon and the left diaphragm) and the falciform ligament act as anatomical dams that block peritoneal fluid and cells from reaching the left hemidiaphragm. - Once trapped between the smooth dome of the liver and the central tendon of the right hemidiaphragm, the endometrial cells implant and erode through the thin tendinous fibers of the right diaphragm (the Halban / Sampson clockwise piston mechanism).

2. Cyclical Diaphragmatic Fenestrations (The "Swiss-Cheese Diaphragm")¶

During each menstrual cycle, rising estrogen stimulates the ectopic endometrial implants on the right diaphragm to proliferate, and the sudden drop in progesterone just before menstruation causes those implants to undergo ischemic necrosis, bleeding, and sloughing: - Over repeated cycles, this enzymatic tissue destruction punches 1-millimeter to 10-millimeter circular full-thickness holes (diaphragmatic fenestrations) right through the central tendon of the right diaphragm (often accompanied by dark brown or blueberry-colored hemosiderin/endometriotic nodules surrounding the holes).

3. Transdiaphragmatic Air Passage (Loss of the Cervical Mucus Plug)¶

During most of the month, a thick, viscous cervical mucus plug seals the uterine cervix, separating the outside atmosphere from the peritoneal cavity. During menstruation: - The cervical mucus plug dissolves and the uterine cervix opens slightly to expel menstrual blood. - As the woman walks, breathes deeply, or exercises, the piston-like movement of the diaphragm creates negative subdiaphragmatic suction (minus 10 to minus 20 cmH2O) that can draw small amounts of air retrograde through the vagina, uterus, and fallopian tubes into the peritoneal cavity, where it rises up the right paracolic gutter and passes directly through the diaphragmatic fenestrations into the right pleural space (Meigs / Maurer transdiaphragmatic air theory).

4. Prostaglandin F2-Alpha (PGF2a) Surge and Visceral Pleural Implant Rupture¶

Why do some women with catamenial pneumothorax still get a collapsed lung even after having a hysterectomy or tubal ligation? Two additional mechanisms explain these cases: - Visceral Pleural Endometriosis Erosion: Endometrial cells that pass through the diaphragm (or travel via pelvic veins and lymphatics into the pulmonary microcirculation) implant directly onto the visceral pleura covering the lung surface. During menstruation, when these pleural implants slough and bleed, they create a microscopic bronchopleural air leak directly from the lung alveoli into the chest cavity. - Luteolytic Prostaglandin F2-Alpha (PGF2a) Vasospasm and Bronchospasm: During menses, the shedding uterine endometrium releases high systemic concentrations of Prostaglandin F2-alpha (PGF2a) into the bloodstream. PGF2a is a potent bronchoconstrictor and pulmonary vasoconstrictor; in susceptible women with subpleural blebs or bullae, PGF2a-induced bronchiolar spasm traps air and ruptures fragile subpleural alveoli (Rossi-Goplerud prostaglandin theory).

The Four Clinical Presentations of Thoracic Endometriosis Syndrome (TES)¶

While catamenial pneumothorax accounts for nearly three-quarters of all cases, Thoracic Endometriosis Syndrome encompasses four distinct clinical emergencies:

Kufwanisa mambu na lweka na lweka: Pneumothorax cataménien vs Pneumothorax spontané primaire (PSP) vs lymphangioleiomyomatose (LAM) vs Syndrome de Birt-Hogg-Dube¶

Kana nkento yina kele na mvula ya kubuta me monisa nde yandi kele ti maladi ya pulupulu yina me bwa na mbala mosi, minganga mpi bantu yina ke sansaka maladi ya pulupulu fwete swaswanisa Pneumothorax Cataménien ti Pneumothorax Spontané Primaire ya ntama mpi maladi ya pulupulu ya ke monanaka mingi ve yina ke bebisaka bankento (LAM-Hoggbe):-DuBirt

Departema ya Lupitalu ya Ke Talaka Mambu ya Nswalu mpi Lusadisu ya Kifwanisu + ya Bahormone¶

1. Luyalu ya Departema ya Lusadisu ya Nswalu¶

Na ntangu ya nswalu, kutula ngolo na pneumothorax cataménial ke landaka bansiku ya Société thoracique britannique (BTS) mpe ya Collège américain des médecins du thorax (CHEST) ya kuvutula luzingu na mbala mosi na pneumothorax, na kutula dikebi ya mingi na menga yina lenda basika (hémopneumothorax): - Kubwa ya fioti, ya kele ti bidimbu fioti (na nsi ya rim ya 2 cm na hilum): Lenda kusansama ti oxygène supplémentaire à haut-flux mpi kutala na bangunga 4 tii na 6 ti radiografi ya mbala na mbala ya ntulu, na nima ya kukwenda nswalu na ambulatoire ya Chirurgie Thoracique et Gynécologie. - Kubwa ya kati-kati ya nene to ya bidimbu (kuluta 2 cm na hilum to kukonda mpema): Bo ke sansaka yo ti aspiration ya ntunga (canule ya 14G tii na 16G na 2e espace intercostal ligne moyenne claviculaire to 4e/5e espace ligne axillaire antérieure) to inser-bo8ll 14-Français Seldinger pigtail drain ya ntulu** yina me vukana na valve ya kukanga masa to na valve ya Heimlich ya ke tambulaka (kubuya suction négative ya ngolo ya luyantiku kana pulupulu me bwa bilumbu mingi sambu na kubuyisa edema ya bapumo ya ke kuma diaka nene). - Nsadilu ya Diagnostic sambu na IRM mpi CT ya Ntulu: Na ntangu CT ya Ntulu ya bo ke sadilaka mingi ke monaka bifu ya pneumothorax mpi ya hernie ya nene ya diaphragme, **IRM ya Ntulu mpi ya Diaphragme ya Résolution ya Kuluta Bo Ke Salaka yo na mutindu mosi ya siki-siki na NTANGU ya Kumona Menga (Bilumbu 1 tii na 3 ya nzietelo yina ke monanaka ve mbote-mbote) na zulu ya menga ya kuluta ngolo T1/ba implants endometriaux supprimés à la hémidiaphragme ya diboko ya kitata. - Kusadila na mbala mosi maladi ya ntu mpi ya ntu: - Kana mbefo me monana na ntangu ya kumona ngonda ti hémothorax cataménial (effusion pleurale ya diboko ya kitata ya nene ya menga ti hémoglobine yina ke bwa mpi kukonda ngolo na nsi ya diboko ya kitata), ba catheter 8F ya fioti ke kangamaka kukonda mpasi; minganga ke tulaka tube ya ntulu ya 24-Français tii na 28-Français sambu na kukatula menga ya pleura ya ndombe na mvimba na yo (kukanga nzila na fibrothorax ya pulmon yina me kangama), menga ya crossmatch, ke pesaka acide tranexamique na misisa (1 000 mg IV), mpi ke solulaka ti minganga ya ke talaka mambu ya ntulu sambu na kusala operasio ya diagrame ya ntulu. bima ya kutula na nitu. - Kana mbefo me monisa hémoptyse cataméniale (kukosa menga ya mbwaki ya ngolo na ntangu ya kumona ngonda katuka na kisika mosi ya endometrium ya parenchyme), lusansu ya nswalu kele kutula muntu ya kusungama to kubasisa menga na ndambu ya nsi, acide tranexamique nebulisé (500 mg dans 5 mL de saline broxamique normale) plus . embolisation artérielle kana menga me luta 100 mL, mpi kuyantika nswalu agoniste ya GnRH to suppression ya progestine.

2. Sambu na nki VATS ya Standard Ke Sadisaka Ve Kana Bo Yidika Ve Diaphragme (E Nzila ya Kusala Lupasu ya Bitini 3)¶

Ntangu munganga ya thorax ke sala Opération thoracoscopique assistée par vidéo (VATS) na nkento yina kele na pneumothorax ya ke vutukilaka na ndambu ya diboko ya kitata to yina ke vukanaka ti ntangu ya kumona ngonda, kutala nswalu kaka na zulu (apex) ya pulupulu ta konda kibeni maladi yina. Ba protocoles ya bubu yayi ya operation ya thorax ke lomba kuyidika intra-opératoire na bitini tatu (yo kele mbote na kubongisa yau na ntangu to na nziunga ya ntangu ya kumona ngonda ntangu bisika ya endometriose kele ya kufuluka ti ya mbwaki-violet):

1. Kutala mpi Kukatula/Kuyidika Tendon ya Katikati ya Diaphragme na mutindu mosi ya me fwana: Munganga ke balulaka mesa ya operasio na Trendelenburg ya ke baluka, ke vutulaka lobe ya nsi ya diboko ya kitata na zulu, mpi ke talaka na dikebi yonso **centre tendinous ya mvimba ya hémidiaphragme ya diboko ya kitata sambu na **per **fe)1 (1) nsuki ya endometriose ya mbwaki/violet. Na kisika ya kutunga kaka mabulu mosi-mosi (yina kepasulaka mbala mingi misisa ya fyoti), minganga kesalaka kukatula kitini ya misisa yina bo metobula na nsadisa ya agrafe endoscopique, bo ketulaka diaphragme, mpi bo kefikaka misisa yonso ya kati-kati sambu na kupesa yo ngolo ti bima yina bo kebingaka péripocarpyly/ biologique (PTcarpybodivile) aside poliglicolique) nsinga.
2. Wedge Resection of Visceral Pleural Endometriotic Implants and Apical Blebs: Any brown hemosiderin spots or subpleural blebs on the right upper, middle, or lower lobes are excised via thoracoscopic wedge resection for histopathological confirmation (using immunohistochemistry staining for Estrogen Receptors [ER], Progesterone Receptors [PR], and CD10 endometrial stroma).
3. Abrasion Pléure Pariétale Totale ou Pléurectomie Partielle / Pleurodése Talque: Kufwa kisika ya pleure mpe kuvukisa ba pulupulu na kibaka ya ntulu mpe na diaphragme, abrasion pleure mecanique, pleurectomie apicale, to poudrage talc stérile keleperforme stérile.

3. Kukanga ba hormone ya ngolo na nima ya kusala operasio (Bangonda 6 tii na 12+)¶

Even after the most meticulous VATS diaphragmatic repair and pleurodesis, microscopic endometrial cells remaining in the chest or pelvis can erode through healing tissue if cyclical monthly estrogen and progesterone surges continue right after surgery. Therefore, joint Thoracic Surgery and Gynecology guidelines mandate immediate post-operative hormonal amenorrhea (suppression of menstruation) for at least 6 to 12 months while pleural fibrosis matures:

• Pont ya ntete na nima ya kusala operasio (Bantu yina ke kangaka to ke kangaka GnRH): Kupesa bantu ntunga ya Nkisi yina ke basisaka ba hormone yina ke basisaka ba Gonadotrophine konso ngonda** mu mbandu **Acétate de leuprolide (*Dépôt de Lupron M2 mg2 to M3 konso ngonda. bangonda)**, Goserelin (Zoladex), to Triptorelin (to bankisi yina ke kangaka GnRH na munoko bonso elagolix to relugolix), kumosi ti bankisi ya nkaka ya bo ke yikaka na dose ya fioti sambu na kutanina densité ya minerale ya mikwa mpi kufiotuna mpasi ya mikwa yina ke basikaka na nitu mpi na kufyotuna mpasi ya nitu yina ke basikaka na nitu. endometrium ya mvimba.
• Kukangama na ntangu ya nda (Dienogest, stérilet/implant ya progestin, to bima yina ke kangaka divumu na munoko): Na nima ya kumanisa bangonda 6 tii na 12 ya lusansu ya agoniste ya GnRH (katula kaka kana mbefo ke meka na kikesa yonso na kubaka divumu na nzila ya FIV), bambefo yina ke landa na kubaka divumu na nzila ya FIV (2 mg konso kilumbu)**, norethindrone acetate ya ke landa, to pillule ya kubuta ya monophasique ya ke landa yina bo ke nwaka na nima-na-nima kukonda bamposo ya placebo/kukatula menga sambu na kubuyisa konso mpasi ya kumona ngonda na bilumbu ke kwisa.

Liste ya mambu yina muntu ya maladi fwete sala: Mutindu ya kulanda mpi ya kupesa maboko sambu na kuzaba maladi¶

Kana nge kele nkento yina me kutanaka ti mpasi mosi to mingi ya "spontane" ya kubwa ya bapumo to mpasi ya nziunga ya ntulu/mapeka yina bo lenda tendula ve:

• Sonika konso kilumbu ya mpasi na ntulu to ya pneumothorax na zulu ya manaka ya nsungi ya kumona ngonda: Sonika kilumbu ya sikisiki ya Kilumbu 1 ya kubasika menga na ntangu ya kumona ngonda (kumona ve kaka matonsi) mpi kilumbu ti ngunga ya sikisiki yina mpasi na ntulu to kukonda mpema yantikaka. Konso kima yina kele na kati ya kukatula bangunga 24 tii na kuyika bangunga 72 ya Kilumbu 1 ke lungisa ntendula ya ngolo ya diagnostic ya pneumothorax cataménial.
• Yula munganga na nge ya thorax na ntwala ya VATS: "Keti nge ta tala tendon ya kati-kati ya diaphragme na mono ya diboko ya kitata sambu na kuzaba kana yo kele ti ba fenestrations mpi kufika yo ti mesh?" Nata kopi ya bo me niema ya bantuma ya endometriose ya thorax kana yo kele mfunu.
• Lomba munganga ya maladi na kutula mukubu na konso mukanda ya pleura to ya diaphragme yina bo me katula sambu na kuzaba CD10, récepteur d’éstrogène (ER), mpi récepteur de progestérone (PR): Ba diapositives ya H&E ya bo ke sadilaka mingi ke tubaka mbala mingi nde “fibrose chronique non spécifique mpi ba macrophages hémosidérines” katula kaka kana ba récepteurs endométriques endométriques spécialisés.
• Schedule an endometriosis specialist gynecology consultation alongside your thoracic surgeon: Up to 60 to 80 percent of women with catamenial pneumothorax have concurrent pelvic and diaphragmatic endometriosis that requires coordinated hormonal suppression.

Banimero ya urgence ya kizunga mpi bantuma ya kimunganga¶

• United States and Canada: Call 911 for acute chest pain, shortness of breath, or hemoptysis. Follow American College of Chest Physicians (CHEST), American Thoracic Society (ATS), and American College of Obstetricians and Gynecologists (ACOG) guidelines on Thoracic Endometriosis Syndrome and extrapelvic endometriosis management.
• Royaume-Uni: Binga 999 sambu na mpasi ya ngolo ya kupema to mpasi ya ngolo na ntulu ya pleuritique. Nsikudukusu ya Société britannique de la thorax (BTS) pour la maladie pleurale (2023) kele na kitini mosi ya me bongisama na yina me tala Pneumothorax cataménial mpe endometriose thoracique, yina ke pesa ba ndongisila ya kusala inspection ya lipaso ya thorax ya kuvukisa na nzila ya hormone ya diaphragme mpe ya managementologique ya ba nkento.
• Union européenne: Binga 112 na ba insi yonso ya UE. Landa nzila ya Société européenne de la respiration (ERS) / Société européenne des chirurgiens thoraciques (ESTS) / Société européenne de la réproduction humaine et de l’embriologie (ESHRE) ya ke tadila mambu ya endometriose.
• Australie na Nouvelle-Zélande: Binga 000 na Australie to 111 na Nouvelle-Zélande. Landa Société thoracique d’Australie et de Nouvelle-Zélande (TSANZ) mpe RANZCOG Nsikudukusu ya banzikisa ya luzingu ya Australie: Endometriose.

Bangyufula yina bantu keyulaka mbala na mbala¶

Sambu na nki pneumothorax cataménial kesalamaka na bapumo ya diboko ya kitata na bantu 90 na kati ya nkama na kisika ya kusalama na bapumo yonso zole kiteso mosi?¶

Na kati ya divumu, ba courant ya masa ya kimuntu yina kepusaka na kutambula ya misopo mpi na kupema ketambulaka na mutindu mosi ya kekwendaka na ndambu ya ntangu: masa kekwendaka na zulu na ndambu ya diboko ya kitata ya divumu (gouttière paracolique ya diboko ya kitata) mbala mosi na kisika yina kele na kati ya ntulu ti ndambu ya diboko ya kitata ya diaphragme, na ntangu ligaments falcoliques yina kele na ndambu ya diboko ya kimama ( ligaments phacico) kekatukaka na ndambu ya diboko ya kimama. kukuma na diaphragme ya diboko ya kimama. Sambu baselile ya endometrium yina mebwaka ketambulaka na zulu ya courant yai ya kekwendaka na ndambu ya ntangu sambu na kukulumuka na diaphragme ya diboko ya kitata mpi kubula mabulu ya fyoti-fyoti (fenestrations) na nzila ya tendon na yo, 85 tii na 95 na kati ya nkama ya bapumo ya cataménial kebwaka na ndambu ya diboko ya kitata.

Inki kele fenetre ya sikisiki ya bangunga 72 yina ketendula pneumothorax cataménien?¶

Na bantuma ya minganga, pneumothorax (pulmon ya kubwa) ketendula catamenial kana mpasi ya ntulu ti kubwa ya bapumo keyantikaka konso kisika yina banda na bangunga 24 NA NTUALA ya kuyantika kubasisa menga tii na bangunga 72 (bilumbu 3) NA NIMA ya kuyantika kubasisa menga ya ngonda. Fenêtre yai ya mvimba ya bangunga 96 ke wakana ti ntangu ya siki-siki yina nivo ya progestérone ke kulumukaka, bima yina bo ke tulaka na kati ya divumu mpi na zulu ya divumu ke katukaka, ba prostaglandine F2-alpha ke kumaka ngolo, mpi mucus ya divumu ke manaka.

Sambu na nki mbala mingi operasio ya bo ke salaka na bapumo (pleurodèse VATS) ke kangaka ve pneumothorax cataménien na kuvutuka?¶

Na pneumothorax spontané primaire standard, munganga ke talaka kaka na zulu kibeni (apex) ya pulupulu sambu na kukanga bibala ya mupepe (blebs) mpi kukumisa zulu ya ntulu ngolo. Na pneumothorax cataménial, mabulu ya kyeleka (fenestrations) kevandaka na nsi mpenza ya ntulu na zulu ya tendon ya kati-kati ya diaphragme ya diboko ya kitata, mpi tissu endometrium yina kesalaka kepesaka mvutu na kubwa ya ba estrogène konso ngonda. Katula kaka kana munganga yina ke salaka operasio me tala mpi me yidika na siki-siki yonso diaphragme ti mesh MPE mbefo ke nwa bankisi yina ke kangaka ba hormone (bonso ba agoniste ya GnRH to ba progestine yina ke landa kusalama) na nsungi ya bangonda 6 tii na 12 na nima ya kusala yandi operasio, kubwa ya bapumo ke vutukilaka kusalama na bambefo 30 tii na 50 na kati ya nkama.

Keti nge lenda vanda ti maladi ya endometriose ya ntulu mpi ya pneumothorax cataménial ata bo me monaka ntete ve nde nge kele ti maladi ya endometriose ya divumu?¶

Yinga. Ata bankento 50 tii na 84 na kati ya nkama yina kebelaka maladi ya pneumothorax cataménial kevandaka mpi ti maladi ya endometriose ya divumu kana bo ketalaka bo mbotembote, tii na bambefo 20 tii na 40 na kati ya nkama kevandaka ve ti maladi ya endometriose na ntwala mpi bo lenda vanda ti bampasi ya fyoti to ya fyoti na divumu. Nkutu, mpasi yina kevutukilaka na ntulu na ndambu ya diboko ya kitata to na pulupulu yina kebwaka na ntangu ya kumona ngonda kevandaka mbala mingi kidimbu ya ntete yina kepusaka minganga na kuzaba maladi ya endometriose ya diaphragme mpi ya pelvique yina kevandaka pima.

Bisika mpi lutwadisu ya leta¶

• Société britannique de thorax (BTS, Royaume-Uni): Nsikudukusu ya Société thoracique britannique samu na maladi ya pleura (2023), Lusadusu ya pneumothorax cataménial mpe endometriose thoracique.
• Société européenne de la réproduction humaine et de l’embriologie (ESHRE), Société européenne de la respiration (ERS), et la société européenne des chirurgiens thoraciques (ESTS): Ntuadisu ya bisalu ya kimbevo: Diagnostic et gestion multidisciplinaire chirurgicale-hormonelle de l’extracidrométrio-hormone S
• Alifano M, Roth T, Broet SC, Schussler O, Magdeleinat P, Regnard JF (Série de référence de chirurgie du thorax / thoracique): Pneumothorax cataménien: Un étude prospective sur les fenestrations diaphragmatiques, l'expression récepteur de progestérone diaphragmatique, et le VAgTS.
• Société américaine du thorax (ATS) mpe Collège américain des médecins obstetriques et gynécologues (ACOG): Kuwakana ya kimbevo na yina me tala maladi ya ba pulupulu ya cyste mpe ya ke katukaka na ngonda na bankento (Pneumothorax cataménial différentiel, LAM, mpe Syndrome de Birt-Hogg-Dube).
• Kimvuka ya ba minganga ya kubuta ti ya bankento ya Australie ti ya Nouvelle-Zélande (RANZCOG): Ntuadisi ya banzikisa ya luzingu ya Australie: Endometriose (Nzila ya Endometriose ya Ntulu ti ya Diaphragme).

Bantwadisi ya ke wakana¶

• Pneumothorax ya kukonda kukana, bapumo ya kubwa, mpasi na ntulu ya pleuritique, mpi kigonsa ya kuvanda na zulu
• Tension pneumothorax and sucking chest wound first aid
• Kukuma diaka nene ya edema ya bapumo na nima ya kusala thoracentese ya nene to kubasisa masa na nzila ya tube ya ntulu
• Kukosa menga (hemoptyse) mpi kubasisa menga mingi na nzila ya mupepe .
• Ba nimero ya urgence na insi