Recurrent pneumothorax diagnosed as catamenial after videothoracoscopic examination of the pleural cavity.

We describe a case of catamenial pneumothorax due to a diaphragmatic defect that was confirmed and treated through the thoracoscopic approach. The patient was a 34-year-old woman who had 3 episodes of right chest pain and shortness of breath, each time starting on the day preceding her menstruation. During thoracoscopy, pathologic changes in the central tendon were apparent, as a 2-mm defect in the diaphragm was discovered. The defect was sutured. Apical pleurectomy and chemical pleurodesis were applied. According to the literature, suspicion of catamenial pneumothorax requires detailed examination of the diaphragm. Every effort, such as pleurectomy and pleurodesis, with postoperative hormonal therapy, should be added to treatment, owing to the high probability of recurrence.