| Abstract [eng] |
Pneumothorax is a common clinical condition that may also be life-threatening, and when it occurs without an external cause it is defined as spontaneous pneumothorax. The incidence of this condition is generally higher in men, but it also occurs to a significant extent in women. In addition, there are clinical and epidemiological differences between the sexes. The aim of this literature review is to examine the existing knowledge in the literature regarding spontaneous pneumothorax in women, to examine the various etiologies unique to this population, and to emphasize the differences between the sexes. The literature search used medical database, including PubMed, along with relevant clinical guidelines and textbooks, focusing on spontaneous pneumothorax in women and its unique etiologies. In many cases, women are initially diagnosed with primary spontaneous pneumothorax, which is later revealed to be secondary spontaneous pneumothorax due to an underlying disease, particularly when the cause is an etiology unique to women. One etiology unique to women that leads to the development of spontaneous pneumothorax is catamenial pneumothorax. This condition is associated with thoracic endometriosis syndrome and is characterized by high recurrence rates, sometimes even after surgical intervention. Another etiology unique to women is lymphangioleiomyomatosis. This disease is a low-grade neoplastic condition characterized by diffuse cystic changes in the lung parenchyma, and spontaneous pneumothorax is one of its main presentations. The recurrence rate of pneumothorax among patients with LAM is particularly high, and therefore in most cases preventive treatment such as pleurodesis is performed already after the first episode. Pregnancy may also lead to pneumothorax in women, although this is a rare condition with limited documentation in the literature. Unlike in men, when spontaneous pneumothorax occurs in women due to these unique etiologies, there is a significant need for accurate diagnosis of the underlying cause and for targeted treatment of it, rather than focusing only on the acute pneumothorax event. In addition, multidisciplinary management of these patients is essential. Available data indicate that there are currently significant gaps regarding the diagnosis and management of spontaneous pneumothorax in women, including the absence of management guidelines tailored to this population, underdiagnosis of etiologies unique to women, and a lack of studies on this topic. These gaps highlight the need to develop dedicated clinical guidelines for the management of spontaneous pneumothorax in women, as well as to conduct further research relevant to the etiologies unique to this population. |
