Symptomatic unilateral idiopathic giant bullous emphysema : a case report

BMC Pulm Med. 2022 Sep 9;22(1):341. doi: 10.1186/s12890-022-02135-3.

Abstract

Background: Idiopathic Giant Bullous Emphysema (or Vanishing Lung Syndrome) is a rare condition which is usually associated with male gender, active smoking and underlying emphysematous disease. We present an unusual case of a giant bulla occurring in the absence of these risk factors.

Case presentation: A 54-year-old woman presented to the respiratory outpatient clinic with gradually worsening left sided chest discomfort, which was most marked during a recent flight. She had no significant dyspnoea or other symptoms. She had a remote 5-pack-year smoking history. Chest X-Ray revealed a large hyperlucent area in the left upper lobe. CT Thorax found this to be an isolated bulla occupying more than one-third of the hemithorax. The remaining lung parenchyma was normal. A diagnosis of Idiopathic Giant Bullous Emphysema was made. The patient was referred for VATS (Video-assisted thoracoscopic surgery) bullectomy which was carried out without complication. Her symptoms resolved completely following the operation.

Conclusions: This is an unusual case of a solitary giant bulla occurring without major risk factors or underlying lung disease. VATS bullectomy was shown to be an effective therapeutic option, allowing re-expansion of compressed lung tissue and complete resolution of symptoms.

Keywords: Bullectomy; Case report; Giant bullous emphysema; Solitary bulla; Vanishing lung syndrome.

Publication types

  • Case Reports

MeSH terms

  • Blister / surgery
  • Dyspnea
  • Emphysema* / diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Emphysema* / diagnosis
  • Pulmonary Emphysema* / surgery
  • Thoracic Surgery, Video-Assisted