Giant pulmonary bullae in children

Negussie, Tihitena; Haile, Luwam; Gebreselassie, Hana Abebe; Temesgen, Fisseha; Tizazu, Ayalew

doi:10.1016/j.epsc.2020.101569

Cited by 3 publications

(7 citation statements)

References 20 publications

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Section: Resultsmentioning

confidence: 99%

“…Bullae is a subpleural air filled space within the lung with the diameter of greater than 1 cm in the distended state, with well demarcated thin wall ≤1 mm. This air containing lesion can be single or may have multiple septations and lies within the lung parenchyma (Negussie et al, 2020). Most patients with bullae have a significant cigarette smoking history, although cocaine smoking, pulmonary sarcoidosis, alpha 1-antitrypsin deficiency, 1-antichymotrypsin deficiency, Marfan's syndrome, Ehlers-Danlos syndrome and inhaled fiberglass exposure have all been implicated (Goldberg & Carey, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Lung Bullae Due to Septic Pulmonary Embolism in a 4-Year-Old Child: A Case Report

Widiastari¹,

Graha²,

Pardede³

2022

COMORBID

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Bullous lung disease in pediatric patients is a rare case. The etiology of lung bullae is cigarette smoking history, pulmonary sarcoidosis, alpha 1-antitrypsin deficiency and many more. One of the treatments for lung bulla is surgical approach. We present a case of 4-year-old girl with lung bulla due to septic pulmonary embolism. Primarily the patient was admitted with a decrease in consciousness, fever, cough and dyspnea. A CT scan revealed bilateral bullae, multiple nodules in various size, mostly with internal cavities and feeding vessel sign suggestive of a septic pulmonary embolism accompanied by a pneumothorax. We did thoracotomy, wedge resection and pleurodesis, the outcome was clinical improvement and no postoperative complication occurred. Thoracotomy, wedge resection and pleurodesis can be considered as a treatment for lung bulla in pediatric population, so this case report may provide guidance on management of these cases for clinicians.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lung Bullae Due to Septic Pulmonary Embolism in a 4-Year-Old Child: A Case Report

Widiastari¹,

Graha²,

Pardede³

2022

COMORBID

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“…2,14 Dyspnoea was the most common presenting complaint with chest pain in 42 (87.5%) and cough in 28 (58.3%) all being higher than reported by Zhu et al 2,12 CXR is the most frequently available investigation on presentation whereas CT scan remains the most valuable investigation. 17,18 CT scan not only aids in defining GB and underlying lung but also helps to differentiate bullae from pneumothorax by the presence of double bubble sign. 17,18 Bullectomy has been advocated as supreme procedure and traditionally open thoracotomy was performed.…”

Section: Discussionmentioning

confidence: 99%

“…17,18 CT scan not only aids in defining GB and underlying lung but also helps to differentiate bullae from pneumothorax by the presence of double bubble sign. 17,18 Bullectomy has been advocated as supreme procedure and traditionally open thoracotomy was performed. 2,3,16,17,19 Over the years it was established that open procedure resulted in worsening of reserves and excessive tissue removal, therefore video assisted thoracoscopic surgery (VATS) was preferred.…”

Section: Discussionmentioning

confidence: 99%

Clinical Results After Intra-Cavitary Drainage of Giant Bullae in Patients With Poor Pulmonary Reserves

Lodro¹,

Mazcuri

Ahmad³

et al. 2023

J Ayub Med Coll Abbottabad

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Background: Giant bullae (GB) are space occupying lesions associated with chronic respiratory symptoms. The aim of this study is to evaluate outcome of intra-cavitary tube drainage procedures (ITDP) in terms of clinical and radiological benefits. Methods: A prospective study was conducted in The Department of Thoracic Surgery, Jinnah Postgraduate Medical Center, Karachi, from February 2021 to April 2022 after ethical approval. Patients above 12 years, with poor reserve and GB underwent clinical, radiological and laboratory assessment before and after ITDPs to document various studied parameters. Results: A total of 48 patients were included; thirty-two (66.7%) were males. Mean age was 46.7±12.14 years. Most common aetiology was COPD (28; 58.3%). GB were ≥10 cm in size in 36 (75%) with right upper lobe involvement in 20 (41.7%). Preoperative dyspnoea score of IV was seen in 41 (85.4%) and chest pain in 42(87.5%) patients. In 34(70.8%) patients, Monaldi procedure and in 14 (29.2%) Brompton technique was used. Dyspnoea score improved from grade IV to II (24/41; p=0.004) along with reduction in pain and cough (p=0.012; p=0.002), respectively. Improvement post operatively in oxygen saturation, forced vital capacity, forced expiratory volume in 1 sec (6.08±1.36%, 0.73±0.516 L and 0.57±0.07 L, respectively, p<0.001) was seen. Partial pressure of oxygen (PaO2) and carbon dioxide improved by 40.6±4.82 (p=0.009) and 13.22±3.62mmHg (p=0.7). Improvement of PaO2 was associated with reduction in the size of bullae (9.33±5.13cm; p=0.006). Radiographical resolution was seen in 41 (87.5%) majorly within 2 months (21; 51.2%). Duration of hospital stay was 4.20 ±0.92 days with no mortality. Complications were seen in 25 (52.1%) patients. Conclusion: intra-cavitary tube drainage procedures allow both clinical and physiological improvement in patients with GB. They allow resolution of bullae in patients with poor reserves and help in expansion of underlying compressed lung, improving both the clinical symptoms and radiological picture.

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“…Bullae are not commonly seen in childhood in contrast to emphysematous bullae commonly seen in adults. 1 Large bullae sometimes get misinterpreted as pneumothorax or tension pneumothorax and subsequently an intercostal drain is inserted. Vanishing lung syndrome is the term sometimes used to denote large lung bullae occupying the whole of the hemithorax.…”

Section: Introductionmentioning

confidence: 99%

Excision of a giant lung bulla in a child: Repair of bronchial leaks using redundant bullous wall/membrane

Goyal

Pahade

Misra

2022

Asian Cardiovasc Thorac Ann

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Large lung bullae are rare in children. We report a rare case of a large bulla in the right lung causing compression of the underlying lung with a shift of the mediastinum to the contralateral side. Excision of the bulla was done and a novel technique was used in the repair of bronchial air leakage sites with part of the bullous wall/membrane. The patient recovered well with re-expansion of the underlying collapsed lung.

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Giant pulmonary bullae in children

Cited by 3 publications

References 20 publications

Lung Bullae Due to Septic Pulmonary Embolism in a 4-Year-Old Child: A Case Report

Lung Bullae Due to Septic Pulmonary Embolism in a 4-Year-Old Child: A Case Report

Clinical Results After Intra-Cavitary Drainage of Giant Bullae in Patients With Poor Pulmonary Reserves

Excision of a giant lung bulla in a child: Repair of bronchial leaks using redundant bullous wall/membrane

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