Air-Fluid Levels in Emphysematous Bullae

Sanford, Howard S.; Green, Robert A.

doi:10.1378/chest.43.2.193

Cited by 11 publications

(4 citation statements)

References 6 publications

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“…As with a parapneumonic effusion, the character of the fluid is inflammatory with a high LDH concentration and cell count. While there are older reports of tuberculosis, congestive heart failure and carcinoma causing air‐fluid levels in bullae; 17,18 today, most are the result of adjacent bacterial pneumonitis.…”

Section: Discussionmentioning

confidence: 99%

Four faces of a parapneumonic effusion: Pathophysiology and varied radiographic presentations

Heidecker

Sahn

2007

Respirology

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We report a patient methicillin-resistant Staphylococcus aureus pneumonia who developed fluid collections in three spaces in the thorax, the pleural space, the pericardial space, and a pre-existing bulla, in addition to mediastinal oedema. We discuss the universal pathogenesis for the development of these fluid collections and the explanation for the most common presentation being a parapneumonic effusion.

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Section: Discussionmentioning

confidence: 99%

Four faces of a parapneumonic effusion: Pathophysiology and varied radiographic presentations

Heidecker

Sahn

2007

Respirology

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“…The reference lists of all identified manuscripts were also searched. In total, seven case series were found [3,[5][6][7][8][9]11 included. The case series were reviewed by one of the authors (D. Chandra) to identify those where the fluid was noted to have developed in pre-existing emphysematous bullae.…”

Section: Identification Of Prior Studiesmentioning

confidence: 99%

“…As patients with COPD can develop a variety of cavitary lung lesions, identifying the correct diagnosis can be challenging [1][2][3]. The diagnosis of fluid-containing emphysematous bulla can only be made with certainty if there is interval development of a fluid level in a pre-existing emphysematous bulla [4,5].…”

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confidence: 99%

Fluid-containing emphysematous bullae: a spectrum of illness

Chandra¹,

Rose²,

Carter³

et al. 2008

Eur Respir J

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Fluid-containing emphysematous bullae are an under-reported complication of chronic obstructive pulmonary disease. The roles of bronchoscopy in the work-up and of antibiotics in the treatment are undefined.This study reports the combined results from the analysis of 16 cases treated at the present authors' institution and 36 previously reported cases.The median age at presentation was 58 yrs and the median duration of follow-up was 60 weeks. A third of the patients were asymptomatic, while two-thirds presented with symptoms, including 10% who had evidence of a severe lung infection. Methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and Bacteroides melaninogenicus were cultured from the bullae fluid in three symptomatic patients. Sputum and blood cultures were uninformative. Bronchoscopy, performed in two-thirds of the cases, added no diagnostic information. Antibiotic treatment did not result in a more rapid resolution of the air fluid level. Percutaneous drainage was safe and effective in four patients.In conclusion, patients with fluid-containing bullae present with a spectrum of illness. Antibiotic treatment does not hasten radiographic resolution and bronchoscopy has no diagnostic or therapeutic role.

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“…Andere Autoren stellen als mögliche Ursache für Blutungen in Bezirke bullösen Emphysems gleichzeitige Antikoagulantientherapie (KENT 1965) oder gleichzeitig bestehenden Lungenkrebs (SANFORD et al 1963) fest.…”

Section: Blutungen Durch Gefäßarrosionunclassified

Perfusionsstörungen

Mittermayer¹

1983

Spezielle Pathologische Anatomie

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Die morphologische Unterscheidung zwischen Thrombose und Thromboembolie ist oft schwer, mitunter unmöglich. So wird auch in der Literatur nicht immer exakt unterschieden zwischen dem in situ entstandenen Thrombus der Pulmonalarterien und dem embolisch in die Pulmonalarterien verschleppten Thrombus, was eine exakte Angabe der Häufigkeitsrelation beider Ereignisse erschwert. Generell läßt sich aber sagen, daß der Verschluß der Pulmonalarterien durch autochthone Thromben häufig vorkommt (KEATING et al. 1953), allerdings seltener als die Thromboembolie der Pulmonalarterien (BALL et al. 1956). Die Thrombose der Pulmonalarterien soll hier nur in soweit besprochen werden, als sie sich von der Thromboembolie, die im folgenden Kapitel ausführlich behandelt wird, unterscheidet. BALL et al. (1956) führen in ihrer Untersuchung über Thrombose und Thromboembolie der großen Pulmonalarterien folgende Unterscheidungskriterien an:1. Das Vorliegen lokaler Erkrankungen der Pulmonalarterien, beispielsweise von Atherosklerose, spricht für die in situ-Thrombose.2. Der autochthone Thrombus paßt im Gegensatz zu dem gewunden vorliegenden Embolus genau in das Gefäß.3. Der in si tu-Thrombus läßt eine schichtweise Ablagerung erkennen, wobei die einzelnen Lagen annähernd parallel zur Arterienwand verlaufen.

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Air-Fluid Levels in Emphysematous Bullae

Cited by 11 publications

References 6 publications

Four faces of a parapneumonic effusion: Pathophysiology and varied radiographic presentations

Four faces of a parapneumonic effusion: Pathophysiology and varied radiographic presentations

Fluid-containing emphysematous bullae: a spectrum of illness

Perfusionsstörungen

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