Case Report

Large Pulmonary Bullae, Resulting from Tuberculosis, in the Context of Extensive Pneumothorax Caused by a Penetrating Chest Wound

Abstract

Pulmonary bullae typically occur either idiopathically or in the context of chronic obstructive pulmonary disease and pulmonary infections. Clinical manifestations of pulmonary bullae include cough, shortness of breath, and chest pain. In some cases, they may be asymptomatic. Differentiating between pneumothorax and pulmonary bullae can be challenging when they coexist. Therefore, obtaining a detailed patient history, conducting a physical examination, performing laboratory tests, and utilizing radiology studies are essential diagnostic tools that should be employed simultaneously. In this case report, we present a patient who developed a wide pneumothorax due to a penetrating chest wound caused by a knife. Initially, the large lung cavity, which had already formed due to tuberculosis, was misdiagnosed as a loculated pneumothorax.

[1] Kolodii M, Azzam S, Peer M. Thoracoscopic giant lung bullaectomy: our initial experience. J Cardiothorac Surg. 2022;17(1):37.
[2] Sharma N, Justaniah AM, Kanne JP, Gurney JW, Mohammed T-LH. Vanishing lung syndrome (giant bullous emphysema): CT findings in 7 patients and a literature review. J Thorac Imaging. 2009; 24(3):227- 30.
[3] Siddiqui NA, Mansour MK, Nookala V. Bullous emphysema. StatPearls [Internet]: StatPearls Publishing; 2021.
[4] Heo J, Bak SH, Ryu SM, Hong Y. Tuberculosis-Infected Giant Bulla Treated by Percutaneous Drainage Followed by Obliteration of the Pulmonary Cavity Using Talc: Case Report. J Chest Surg. 2021; 54(5):408-11.
[5] Aramini B, Ruggiero C, Stefani A, Morandi U. Giant bulla or pneumothorax: How to distinguish. Int J Surg Case Rep. 2019; 62:21-3.
[6] Urbanowski ME, Ordonez AA, Ruiz-Bedoya CA, Jain SK, Bishai WR. Cavitary tuberculosis: the gateway of disease transmission. Lancet Infect Dis. 2020;20(6):e117-e28.
[7] garg I, Agarwal KC, Purohit G, Agarwal S, Umashankar N. Giant Bulla or Tension Pneumothorax: Diagnostic Dilemma in Emergency. Chest. 2016;150(4):929A.
[8] Samanta RP, Agarwal S, Sengupta S. Giant Bullous Emphysema Mimicking Spontaneous Pneumothorax. Cureus. 2022; 14(11):e31182.
Files
IssueVol 10 No 3 (2024): Summer QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/aacc.v10i3.15699
Keywords
Tuberculosis Pulmonary Bullae Case Report Pneumothorax

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How to Cite
1.
Rahat Dahmardeh A, Heidari M, Keykha A. Large Pulmonary Bullae, Resulting from Tuberculosis, in the Context of Extensive Pneumothorax Caused by a Penetrating Chest Wound. Arch Anesth & Crit Care. 2023;10(3):284-288.