The vanishing lung: an important cause of hyperlucency on chest radiograph

Faruqi, Shoaib; Varma, Ravi

doi:10.52964/amja.0309

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…GBE poses a unique challenge in clinical practice due to its overlapping radiological findings with tension pneumothorax. In GBE, on plain radiographs, large asymmetrical bullae appear as a unilateral hyperlucency similar to the hyperlucency found in tension pneumothorax [ 6 ]. Additionally, GBE may exhibit a contralateral mediastinal shift similar to that of a tension pneumothorax [ 7 - 8 ].…”

Section: Discussionmentioning

confidence: 99%

Differentiating Giant Bullous Emphysema From Tension Pneumothorax: A Case Report

Ascano,

Kramer,

2024

Cureus

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Giant bullous emphysema (GBE) is a progressive disease that commonly presents with severe progressive dyspnea attributed to the progressive destruction of alveolar walls and the formation of large air pockets, resulting in impaired gas exchange. This presentation is most commonly seen in young, thin male smokers. GBE poses an interesting and unique clinical challenge due to its radiologic findings, which can be easily mistaken for tension pneumothorax. Despite the decreased acuity of GBE as compared to tension pneumothorax, inadequate treatment in a severe case can lead to spontaneous pneumothorax, infection, and/or respiratory failure. In this report, we highlight a case of severe GBE that presents similarly to tension pneumothorax in both symptomatology and radiologic findings. The case at hand is of a 50-year-old male patient with a history of chronic obstructive pulmonary disease (COPD) with complaints of dyspnea and subsequent findings of tachycardia, tachypnea, and hypoxemia with significantly decreased breath sounds in the right lung. Radiologic findings showed increased lucency of the right hemithorax and a mass effect with a mediastinal shift to the left. History and further imaging with CT led to an ultimate diagnosis of severe GBE and COPD exacerbations. The patient was treated with non-invasive medical management. With the challenges of overlapping presentations, landing on the correct diagnosis is imperative to accurately and adequately treat the patient since GBE and tension pneumothorax significantly differ in acuity and overall management, hence the need for a high level of suspicion based on the clinical picture and the use of high-resolution CT.

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Section: Discussionmentioning

confidence: 99%

Differentiating Giant Bullous Emphysema From Tension Pneumothorax: A Case Report

Ascano,

Kramer,

2024

Cureus

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Localized Hyperlucency in an Acutely Dyspneic Patient: Always a Pneumothorax?

Dua

Singhal

2016

The Journal of Emergency Medicine

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Challenges in diagnosis and treatment of pneumothorax and giant bullae

Корымасов

Benian

Bogdanova

et al. 2021

Pulʹmonologiâ (Mosk.)

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Spontaneous pneumothorax is the most common acute chest disease. Often, giant bullae give the impression of the presence of air in the pleural cavity. Inadequate differential diagnosis leads to vain drainage of the pleural cavity, damage to the lung with its collapse and pneumothorax.The aim. Analyze diagnostic and tactical mistakes in patients with pulmonary emphysema, which manifests with giant bullae, and outline the ways to prevent complications.Methods. The analysis of the treatment of 1,636 patients with pulmonary emphysema and its complications undergoing treatment in the thoracic surgical department of the Samara Regional Clinical Hospital named after V.D.Seredavin in the period from 2001 to 2018 is presented.Results. Giant bulla were diagnosed in 35 (2.1%) patients, 16 of them were hospitalized ungently. In 6 patients, the diagnosis of a giant bulla of the lung was correct, and the patients were referred to the thoracic surgical department. In 10 patients, a giant bulla of the lung was regarded as pneumothorax, and pleural drainage was performed before referral to the thoracic surgical department.Conclusion. The correct interpretation of the radiological data and comparison with the clinical picture allows avoiding diagnostic errors and the associated danger and complications.

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The vanishing lung: an important cause of hyperlucency on chest radiograph

Cited by 4 publications

References 10 publications

Differentiating Giant Bullous Emphysema From Tension Pneumothorax: A Case Report

Differentiating Giant Bullous Emphysema From Tension Pneumothorax: A Case Report

Localized Hyperlucency in an Acutely Dyspneic Patient: Always a Pneumothorax?

Challenges in diagnosis and treatment of pneumothorax and giant bullae

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