[Successful surgical repair of emphysematous giant bullae of the elderly with severely depressed pulmonary function]

Abstract

A 71-year-old male was admitted to an emergency hospital owing to severe dyspnea of sudden onset. Bilateral tension pneumothorax with two giant bullae occupying more than the third of the right lung was disclosed on the chest X-ray. Bilateral chest drainages and cardiopulmonary resuscitation were performed. He could be freed from ventilatory support several days after tracheostomy and was referred to our hospital. The pulmonary function was severely depressed: VC (%) 1.20 l (40%) and FEV1.0 (%) 0.55 l (46%). In spite of oxygen inhalation he could not keep sitting due to dyspnea (Hugh-Jones grade V). Right multiple bullectomy was performed successfully and his postoperative course was uneventful. He was discharged eight weeks later. Seven months after surgery his pulmonary function was remarkably improved: VC (%) 2.05 l (64%) and FEV1.0 (%) 0.94 l (46%). He became to walk almost equally with a healthy man one year later (Hugh-Jones grade II).