title: Why a chest physician should be interested in abdominal pain.
abstract: A 37-year-old woman presented at casualty with a 1-day history of progressive spontaneous left iliac fossa pain. She was having her menstruations for 4 days. She had no respiratory symptoms. Her medical history consisted of laparoscopic surgery for endometriosis and ovarian cysts. A very small right basal pneumothorax with visualisation of a hypervascular nodular lesion on the right diaphragm was incidentally noticed on the right diaphragm. We suspected here a catamenial pneumothorax. During video-assisted thoracoscopy the surgeon observed in the centrum tendineum of the diaphragm a small and a large perforation with partial intrathoracic herniation of the liver, but without visible diaphragmatic or pleural endometriosis. The surgeons converted to a small anterior thoracotomy in order to reinforce the large perforation with interrupted non-absorbable sutures and plication of the smaller perforation, and finally performed a mechanical pleural abrasion with a surgical pad.
authors.affiliation: Department of Pneumology, University Hospitals Leuven, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Bostoen
authors.forename: D
authors.initials: D
authors.lastname: Van Raemdonck
authors.forename: C
authors.initials: C
authors.lastname: Dooms
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000328:Adult; D003964:Diaphragm / Q000293:injuries* / Q000601:surgery; D005260:Female; D006549:Hernia, Diaphragmatic, Traumatic / Q000150:complications* / Q000209:etiology / Q000601:surgery; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000209:etiology / Q000601:surgery; D008598:Menstruation; D011030:Pneumothorax / Q000150:complications / Q000209:etiology* / Q000601:surgery; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy; D016896:Treatment Outcome