Thoracic endometriosis: explained

Thoracic endometriosis involves the presence of endometrial tissue in the lungs or chest cavity, causing symptoms like chest pain, coughing blood, and shortness of breath, often linked to menstrual cycles. Distinguished consultant gynaecologist and advanced laparoscopic surgeon Mr Hemant Niranjan Vakharia provides an overview to the condition, including its complications and diagnosis.

What complications can it cause (e.g. collapsed lungs, air and blood in the chest cavity, etc)?

Thoracic endometriosis is a condition which may result in several complications, including:

Pneumothorax: This occurs when air leaks into the space between the lungs and the chest wall, potentially causing lung collapse if a significant amount of air accumulates.

Haemothorax: This involves the accumulation of blood in the space between the lungs and the chest wall.

Haemoptysis: This refers to coughing up blood or having blood in the sputum.

These complications can lead to symptoms such as shortness of breath, chest pain, and difficulty breathing. They may occur cyclically around the time of menstruation or at other points in the menstrual cycle as well.

How can it be diagnosed?

Thoracic endometriosis can be diagnosed based on clinical suspicion, especially in young women experiencing symptoms such as cyclical chest pain, shortness of breath, or difficulty breathing. It should also be considered if a pneumothorax occurs in a young woman.

Imaging strategies vary depending on the patient's symptoms and may include chest x-ray, CT scan, or MRI. However, diagnosis can be challenging in some cases. Video-assisted thoracoscopy, a procedure where the lung cavity is inspected with a camera, may be recommended if imaging fails to confirm the diagnosis. This procedure not only aids in diagnosis but also allows for the treatment of endometriosis if found during the inspection.

What treatment is there for people with thoracic endometriosis?

The treatment approach for thoracic endometriosis depends largely on the patient's presentation. In cases of pneumothorax with significant air volume, initial air drainage may be necessary. To prevent recurrence, a surgical procedure called pleurodesis may be performed to fuse together the layers of tissue covering the lungs (pleura) where the air had accumulated.

In some patients, excision (surgical removal) of endometriotic lesions and repair of affected areas may be performed. Tissue removed during surgery is typically sent to the laboratory for confirmation of endometriosis.

Medical therapies, similar to those used for pelvic endometriosis, may also be employed. While these treatments do not eliminate endometriosis, they can help alleviate symptoms.

If you would like to book a consultation with Mr Vakharia, simply visit his Top Doctors profile today.