Thoracic endometriosis syndrome (TES) is uncommon disease presented as catamenial pneumothorax, hemothorax, lung nodules and hemoptysis occurring within first 48-72 hours of menstruation. Endometriosis affects about 10% of women in reproductive age; incidence of extrapelvic endometriosis in these women is approximately 12%. The most frequent presentation of TES is pneumothorax (about 74%) while hemothorax is rare TES presentation (14%). The diagnosis is almost always established on clinical grounds.

Keywords: hemothorax, endometriosis, VATS.


We report a case of 32 year old woman presented with dyspnea. History revealed recurrent right pleural effusion coinciding with menstruation. Chest X-ray and MRI showed a right pleural effusion and consequently atelectasis of the lung. Preoperative thoracic drainage yielded 2000 ml bloody fluid.


Treatment was achieved by VATS. Adhesiolysis, lung decortication and total parietal pleurectomy were performed. Postoperative histopatological examination of the pleura showed pleural endometriosis. Patient is now, 3th year follow up, clinically and radiologically asymptomatic.


In our opinion, VATS total parietal pleurectomy is gold standard for both, diagnosis and treatment of catamenial hemothorax.

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