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Case Reports
. 2022 Sep 9;22(1):341.
doi: 10.1186/s12890-022-02135-3.

Symptomatic unilateral idiopathic giant bullous emphysema : a case report

S Garvey  1 , J Faul  2 , L Cormican  2 , D Eaton  3 , E P Judge  2
Affiliations
Case Reports

Symptomatic unilateral idiopathic giant bullous emphysema : a case report

S Garvey et al. BMC Pulm Med. .

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.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Initial CT imaging; a axial view, b coronal view. CT Imaging demonstrating a solitary giant bulla in the left upper lobe with normal surrounding parenchyma and secondary compression of the left upper and lower lobes
Fig. 2
Fig. 2
Intra-operative image of the giant bulla that was resected during VATS Bullectomy
Fig. 3
Fig. 3
Pulmonary Function Tests. Spirometry demonstrating improvement in forced vital capacity (FVC) and forced expiratory volume in 1st second (FEV1) post-operatively. Lung volumes including total lung capacity (TLC) and residual volume (RV) were not performed pre-operatively. Attempts to measure diffusion capacity were limited by patient technique on both occasions
See this image and copyright information in PMC

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