Did you check the diaphragm? Is it intact?

Yes, we have inspected the diaphagm very carefully during VATS.

No signs of defect.

Now we are waiting for histopathological conclusion concerning "blue spot" wedge pulmonary excision.

As a result of pulmonary wedge resection, if endometriosis is diagnosed, medical treatment is required. You also stated that it is bilateral, in this case it would be good to do VATS on the left side.

The blue spot laesion resected thoracoscopically was diagnosed as lymphatic node (no signs of endometriosis). We started with gestagene hormonal treatment, because of endometriosis in minor pelvic localisation.

So the lesion was a lymph node with out any pathology

Yes, no underlying pathology was detected in wedge resection of dystrophic pulmonary tissue. Because of concomitant minor pelvis endometriosis, we have started with oral gestagene therapy (approx. 6 weeks ago)

thank you for answer

Ricardo Navarro

Thank you for your answer and recommendations.

We hope the medical treatment will be successful, due to the fact, we have performed all relevant surgical procedures before it (pleurabrasia included).

Thank you for your advices. We are to prepare an case report article on this topic.

Best regards

Pavol Omanik

We have started with oral gestagene therapy in our adolescent patient approximately 6 months ago.

Since that there was no recurrency of pneumohorax, moreover a complete regression of ovarial cystic changes connected with pelvic endometriosis were noticed.

Great! I would continue gestagene for 6 more months, then stop treatment and see what happens based just in clinical data and a chest Xray.

Unfortunately, our patient has developed a recurrency after 7 months event-free interval. Apical spontaneuos left-sided pneumothorax occured despite successful hormonal treatment of pelvic endometriosis. The extent of pneumothorax did not require chest tube placement, just clinical obsevation for 24 hours.