In 1958, Maurer described the syndrome of recurring catamenial pneumothorax associated with pelvic and diaphragmatic endometriosis. Since then, similar cases have been reported, indicating that pelvic endometriosis and pleural or diaphragmatic endometrial implants may be present.
On the basis of experience with six patients of our own, and in a review of the literature, we find no support for the explanations so far proposed, eg, that the uterine cavity is the source of air that passes through congenital diaphragmatic defects. Our experience confirms that the syndrome occurs in ovulating women and that symptoms are relieved by hormonal suppression of ovulation; that endometriosis may not be present; and that usually no specific pulmonary process is found. Awareness of this entity will lead to more frequent case findings, thus permitting the determination of its true incidence and the testing of current theories.