Endometriosis pleura and aperture

Endometriosis pleura and aperture. Despite the existing opinion about the rarity of defeat pleura and aperture endometriosis, publications on this subject quite a lot [Bungeler W., Sulveira F., 1939; H. Nicholson, 1951; J. Barnes, 1953; Brews A., 1954; Maurer E. et al., 1958; Ripstein C. et al., 1959; Kovarik J. et al., 1966; Leh So, 1967; Labay G. et al., 1971; Magre J. et al., 1971; Granberg I. et al., 1977].
It should be noted that all messages testified of right-sided process. Only one observation [Granberg I. et al., 1977] was left defeat pleura 35-year-old woman. At the same time, the patient was endometriosis middle lobe of the right lung, the lower lobe of the left lung, endometriosis, pelvic and abdominal cavity. As with endometriosis lungs, the first description of defeat pleura made pathologists W. Bungeler, F. Silveira (1939)that detects the knots of endometriosis in the upper division of the pleura of the corpse 42-year-old woman who died from chronic pneumonia. Endometriosis was located on the right.
Predominantly right-handed defeat pleura and diaphragm due to anatomic relations abdominal and the right pleural cavity.
Distribution of endometriosis of the abdominal cavity plevralnuu possible not only through the available anatomical message in the field of passing the lower hollow vein through the right diaphragm cupola, but after punching a hole formed in the diaphragm as a result of its destruction endometriosis [Brews A., 1954; Maurer E. et al., 1958, and others]. Penetrating with hemorrhagic fluid through the diaphragm elements of the endometrium, or rather endometriosis, implanted in the pleura and give rise to the formation of new centers. This is evidenced by numerous clinical observations, published in the literature, and experimental studies N. Harbitz (1934). Introduced in the pleural cavity-rabbits pieces of the endometrium are well accustomed to the diaphragm, the pleura and grew not only in the direction of the pleural cavity, but also in the bone ribs, up to a cerebral layer. Given the experiment proves a high capacity implanted endometrial not only to engraftment in deleted from sexual organs and tissues, and to the manifestation of proliferative and destructive properties.
The implant engraftment and development of endometriosis pleura and aperture contribute to the presence in the body of patients favorable hormonal and changes in the immune system.
In addition, endometriosis pleura and aperture can be the result of direct distribution process from the lungs, where it occurred due to hematogenous drift of particles of the endometrium. Mainly subpleural location foci of endometriosis in the lungs allows to avoid the possibility of Genesis.
The question of metaplasia of mesothelial pleura in endometriodnoy fabric is still open (see 2 main). However, more correctly to speak about the impossibility of such a transformation.
Typical clinical manifestation of endometriosis pleura and aperture is recurrent hemo - and pneumothorax. The accumulation of hemorrhagic fluid in the pleural cavity often occurs in parallel with the formation of hemorrhagic or light brown ascites in the abdominal cavity and usually coincides with the menstrual days. The accumulation of fluid in the pleural cavity may be accompanied by pain in the right half of the thorax, the advent of cough and fever. However, in observation S. Ripstein et al. (1959) dependence of exacerbation (clusters of hemorrhagic fluid in the pleural cavity, and other symptoms) from menstrual cycle has not been established. The latter may be due to prevalence of endometriosis, just as it takes place in a generalized endometriosis, pelvic and abdominal cavity.

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