Article Text

Download PDFPDF
Learning from errors
Thoracic endometriosis syndrome manifesting as atraumatic haemothorax causing difficult ventilation under general anaesthesia
  1. Mark Peterzan1,
  2. Toby Reynolds2,
  3. Kamaljit Dulay3,
  4. Rachel Wooldridge4
  1. 1Core Medical Training, Barts Health NHS Trust, Newham University Hospital, London, UK
  2. 2Department of Anaesthetics, Barts Health NHS Trust, Newham University Hospital, London, UK
  3. 3Department of Cellular Pathology, Barts Health NHS Trust, Royal London Hospital, London, UK
  4. 4Department of Women's Health, Barts Health NHS Trust, Newham University Hospital, London, UK
  1. Correspondence to Dr Rachel Wooldridge, Department of Women's Health, Barts Health NHS Trust, Newham University Hospital, London, UK; racheljanewooldridge{at}doctors.org.uk

Summary

A 31-year-old woman underwent elective hysteroscopy and laparoscopy for investigation of primary infertility. The procedure was abandoned owing to intraoperative desaturation and reduced right-sided chest movement. Postoperative chest x-ray showed an opacified right hemithorax with tracheal deviation to the left. Retrospectively on direct questioning, she admitted to dry cough, mild dyspnoea and significant weight loss. Diagnostic thoracocentesis and contrast CT scan confirmed heavily blood-stained exudative pleural effusion but were otherwise non-diagnostic. After chest drain insertion, 4.6 litre drained but a hydropneumothorax developed upon drain removal, with no improvement on repeat drain insertion. Right video-assisted thoracic surgery was performed, converted to thoracotomy, with repair of diaphragmatic fenestrations, pleurectomy and decortication of trapped lung undertaken. Histological examination of samples of pleura and lung cortex was pathognomic of endometriosis. She was started on norethisterone with no recurrence to date.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.