Catamenial Pneumothorax is a rare clinical condition that was coined from a Greek root meaning monthly. It classically involves women in the 3rd or 4th decade of life. Since the first description in 1958, Just 229 cases of a unique entity of catamenial Pneumothorax in women have been reported. The etiology of this disease is not clearly known. Endothoracic endometriosis or other unidentified problems make periodic spontaneous Pneumothorax in this patients.The main presentations of this disease are dyspnea and chest pain within 48 to 72 hours from the onset of menstruation. In this paper we discuss etiology, clinical course, and thoracoscopic treatment of a 39 year old woman with catamenial Pneumothorax. In addition, the world literature is reviewed.

Introduction: Catamenial Pneumothorax is a rare disease caused by presence of endometrial tissues in chest cavity showing itself with Pneumothorax 24 to 48 hours after the beginning of menstrual period . A case of Catamenial Pneumothorax is presented here.Case presentation: The case was a 17-year-old young woman admitted to hospital with symptoms and signs including chest pain, dyspnea, tachypnea and decreased breath sounds in right hemithorax started with her menstrual period. The patient had a history of similar attacks in her previous menstrual periods. Right Pneumothorax was observed in the x-ray. Tube thoracostomy was inserted and chemical pleurodesis was administered. Treatment with decapeptil (GNRH analog) injection continued for 6 months.Conclusion: Diagnosis of the disease is clinical. Early diagnosis and treatment is recommended for all the patients in reproductive ages with dyspne, chest pain and Pneumothorax as well as a history of recurring symptoms during the previous menstrual periods.

Background: Spontaneous Pneumothorax occurs without any predictable factor. This leads to accumulation of air in pleural cavity, which can cause dyspnea and in severe cases even death.Methods: This census, descriptive-retrospective study was conducted on patients with spontaneous Pneumothorax treated with pleurodesis chest tube in which tetracycline capsules were saluted, in Isfahan city، Iran، during 2013-16. After completion of treatment, patients were assessed in terms of dyspnea. In case of normal chest X-ray and pulmonary expansion، chest tube was removed. Demographic information and complications were evaluated as well. Data were analyzed using descriptive analytics and chi-square test. P-value<0.05 was considered as significant.Findings: Among 108 patients, 6(5.5%) reported recurrence Pneumothorax in a year. 48 patients mentioned smoking that was not in association with Pneumothorax recurrence (P>0.05). 38 patients (35.1%) reported chest pain after chest tube removal and 8 patients (7.4%) reported fever of more than 38oC.Conclusion: Due to comparing the results of current study with previous similar studies، treatment of spontaneous Pneumothorax with tetracycline capsule causes fewer complications and fewer recurrences.

Objective: Air leak syndromes including Pneumothorax, pneumomediastinum and pulmonary interstitial emphysema are frequent in neonatal period. Mechanical ventilation with positive pressure is one of the most common causes of these syndromes. The aim of this study was to evaluate predisposing factors and incidence of Pneumothorax in newborns under mechanical ventilation.Methods: This descriptive cross sectional study was performed in 400 newborns under mechanical ventilation in intensive care unit of a teaching hospital in Iran from April 2004 to December 2008. Predisposing factors leading to ventilation and incidence of air leak syndromes were studied. Sex, gestational age, birth weight, type of delivery, history of surfactant replacement therapy, ventilator settings and mortality rate were recorded. Statistical analysis was done using SPSS software. Univariate analysis and regression analysis were considered.Findings: Among 400 patients under mechanical ventilation, 102 neonates developed Pneumothorax (26%). Fifty six (54.9%) of them were boys and 46 (45.1%) girls.54.9% of newborns with Pneumothorax were preterm and 45.1% term. Birth weight less than 2500g was recorded in 59.8%. Fifty two percent of these neonates were born by cesarean section vs.32% of newborns without Pneumothorax. The most common type (62.7%) of ventilation leading to Pneumothorax was Inspiratory Positive Pressure Ventilation (IPPV). Surfactant replacement therapy was recorded in 32.4% of cases with Pneumothorax compared to 60.4% of neonates under ventilation without Pneumothorax, which was significantly different (P=0.017).Conclusion: In newborns surfactant replacement therapy can reduce the risk of Pneumothorax caused by mechanical ventilation.

Background/Objective: Air leak syndromes are frequent in neonatal period. Mechanical ventilation with positive pressure is one of the most common causes of these syndromes. The aim of this study was to detect the incidence of Pneumothorax in newborns under mechanical ventilation.Patients and Methods: This descriptive cross sectional study was performed on 400 newborns admitted in the intensive care unit of 22 Bahman Hospital of Mashhad during 1383-1387. All patients were under mechanical ventilation. Sex, gestational age, birth weight, type of delivery, history of surfactant therapy and mortality rate after Pneumothorax were recorded in questionnaires. Statistical analysis was done on the obtained data using SPSS software.Results: Among 400 patients under ventilation, 102 neonates developed Pneumothorax (26%). 55% of these cases were boys and 45% were girls. Pneumothorax was on the right side in 66.7%, on the left side in 12.8% and bilateral in 19.6%. In newborns with Pneumothorax 54.9% were preterm and 45.1% were term. Birth weight less than 2500g was seen in 59.8% of the cases. Among these neonates 19.6% were very low birth weight (under 1500g). In newborns with Pneumothorax, 52% were born with cesarean section and 48% with normal vaginal delivery which was significantly different (P= 0.015). Surfactant therapy was recorded in 32.4% of cases with Pneumothorax. The most common type of ventilation leading to Pneumothorax was Synchronized Intermittent Mandatory Ventilation (SIMV) in 51%, Conventional Ventilation and Continious Positive Airway Pressure (CPAP) were seen in 35% and 12.3% of pneumothoraces, respectively. Conclusion: Male sex, prematurity, birth weight below 2500g, cesarean section, negative history of surfactant therapy were risk factors of neonatal Pneumothorax. CPAP was the least common kind of ventilation in Pneumothorax cases.

Background: Pneumothorax is more common in neonatal period than the rest of the life. In term infants, Pneumothorax is usually asymptomatic. However, premature neonates usually have symptoms particularly when they need mechanical ventilation. The aim of the present study was to investigate the prevalence and risk factors of Pneumothorax among premature infants.Methods: This cross-sectional study was carried out in Alzahra and Shahid Beheshti University hospitals, Isfahan, Iran, in 2010. Neonates with gestational ages of 26-37 weeks hospitalized in neonatal intensive care unit (NICU) were included. Demographic features including gestational age, sex, and birth weight were collected. All neonates who had sudden changes in breathing status were evaluated for Pneumothorax using chest X-ray (CXR). Data were analyzed using Student-t and X2 tests.Findings: Among 303 studied neonates, 29 (9.6%) were suffered from Pneumothorax. Birth weight, gestational age, number of pregnancy and mothers’ chronic diseases were significantly different in two groups (P<0.001 for all). Chest compression, ventilation with bag and mask and needing intubation were statistically different between the two groups, too (P<0.001).Conclusion: Premature neonates are at higher risk for Pneumothorax due to lower birth weight, lower gestational age, higher number of mother’s pregnancy, mother’s diseases during pregnancy; also, interventions such as chest compression, ventilation with bag and mask and intubation procedure is more needed for them. Thus, many cautions during medical intervention must be done for prevention of Pneumothorax.

Aim and Background: Percutaneous tracheostomy, a common surgical procedure in the field of otolaryngology, is associated with complications, such as bleeding, infection, subcutaneous emphysema, Pneumothorax, recurrent laryngeal nerve injury and tracheal ring fracture. However, the incidence of Pneumothorax and pneumoperitoneum in a single individual is rare.Case report: A 70-year-old woman was scheduled to undergo an urgent tracheostomy with dyspnea and severe respiratory distress due to incomplete superior airway obstruction following relapse of medullary thyroid cancer. Approximately two minutes after insertion of the tracheostomy tube, her blood pressure and O2 saturation decreased but airway pressure increased. Physical examinations revealed decreased bilateral breath sounds and diffuse expansion of the abdomen. Immediately an orotracheal tube was inserted up to 10 cm through the orifice of tracheostomy into the trachea. After puncture of the chest and abdomen the air was evacuated and the patient was discharged from ICU after 2 days hospitalization without any adverse event. The proposed mechanisms include: complications related to lack of proper placement of tracheostomy tube due to tumor location, tube dislocation, and barotrauma. Rupture of alveolar walls or bronchial and bronchioles lead to air leakage into the pleural cavity and can cause Pneumothorax. Although the thoracic and peritoneal cavities are separated by the diaphragm, they may communicate through congenital defects, such as a pleuroperitoneal canal or defects adjacent to the aorta or esophagus.Conclusions: Performing tracheostomy, especially in patients with a cervical mass, can be associated with serious and life-threatening events. Attention to the risk of these complications and prompt treatment would reduce the mortality and morbidity rate.