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Communications to the Editor |

Catamenial Pneumothorax and Its Relation to the Peritoneal Stomata of the Diaphragm FREE TO VIEW

Kazuhiro Funatsu, MD; Mizuki Tsuru, MD; Naofumi Hayabuchi, MD
Author and Funding Information

Munakata Suikoukai General Hospital Munakata, Fukuoka, Japan Kurume University School of Medicine Kurume, Fukuoka, Japan

Correspondence to: Kazuhiro Funatsu, MD, Munakata Suikoukai General Hospital, Kamisaigou 341-1, Fukuma-machi, Munakata-gun, Fukuoka, 811-3298, Japan



Chest. 1999;116(6):1843. doi:10.1378/chest.116.6.1843-a
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To the Editor:

The majority of catamenial pneumothoraces (90–95%) are right-sided, and the pathogenesis remains controversial.12

In 1936, Allen3defined peritoneal stomata of the diaphragm as normal openings of the underlying lymphatics. He also reported that intraperitoneal particles and solution are sucked through these openings in mice and that similar stomata also have been recognized in humans.4Diaphragmatic lymphatics represent the major pathway for peritoneal fluid drainage (about 90%) in cats,5and absorption tends to be more extensive on the right side.6

In addition, the subdiaphragmatic lymphatics communicate with the pleural surface,3 and thus, even though not all cases have been proven to have diaphragmatic endometriosis and/or defects,1 the pathogenesis seems mainly to be due to the absorption of intraperitoneal endometrial tissue from the stomata of the right hemidiaphragm. The same phenomenon also seems to play a role in other right-side-predominant diseases (ie, Meigs’ syndrome).

References

Carter, EJ, Ettensohn, DB (1990) Catamenial pneumothorax.Chest98,713-716. [CrossRef]
 
Jos, J, Steven, AS Thoracic endometriosis syndrome: new observations from an analysis of 110 cases.Am J Med1996;100,164-170. [CrossRef]
 
Allen, L The peritoneal stomata.Anat Rec1936;67,89-103. [CrossRef]
 
Li, JC, Yu, SM Study on the ultrastructure of the peritoneal stomata in humans.Acta Anat1991;141,26-30. [CrossRef]
 
Raybuck, HE, Allen, L, Harms, WS Absorption of serum from the peritoneal cavity.Am J Physiol1960;199,1021-1024
 
Yoffey, JM, Courtice, FC Lymph flow from regional lymphatics. Yoffey, JM Courtice, FC eds.Lymphatics, lymph and the lymphomyeloid complex 1st ed.1970,295-309 Academic Press. New York, NY:
 

Figures

Tables

References

Carter, EJ, Ettensohn, DB (1990) Catamenial pneumothorax.Chest98,713-716. [CrossRef]
 
Jos, J, Steven, AS Thoracic endometriosis syndrome: new observations from an analysis of 110 cases.Am J Med1996;100,164-170. [CrossRef]
 
Allen, L The peritoneal stomata.Anat Rec1936;67,89-103. [CrossRef]
 
Li, JC, Yu, SM Study on the ultrastructure of the peritoneal stomata in humans.Acta Anat1991;141,26-30. [CrossRef]
 
Raybuck, HE, Allen, L, Harms, WS Absorption of serum from the peritoneal cavity.Am J Physiol1960;199,1021-1024
 
Yoffey, JM, Courtice, FC Lymph flow from regional lymphatics. Yoffey, JM Courtice, FC eds.Lymphatics, lymph and the lymphomyeloid complex 1st ed.1970,295-309 Academic Press. New York, NY:
 
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