Giant Bulla or Tension Pneumothorax- Diagnostic Dilemma in Emergency: A Case Series
Journal Title: Scholars Journal of Medical Case Reports - Year 2015, Vol 3, Issue 8
Abstract
Abstract: A single giant bulla or multiple emphysematous bullae that coalesce to form a giant bulla can give the impression of tension pneumothorax on chest radiography. We hereby report a series of two rare cases presenting with increased dyspnea having large hyperluscent area on right side with mediastinum shift to the left on chest X-ray. This radiologic pattern was consistent with tension pneumothorax; however, the clinical scenario was not keeping with this diagnosis (absence of shock, jugular venous pressure elevation or muffled heart sounds).Computed Tomography of the chest was done subsequently which revealed a giant emphysematous bulla on right side in both the cases. The relatively stable vitals of the patients at the time of presentation provided us the opportunity to do Computed tomography of Thorax and prevent the undesirous complications of putting intercostals tube in a Bulla. Both the patients were evaluated for surgical intervention as bullectomy is the treatment of choice for giant bulla and referred for cardiothoracic surgery. Keywords: Giant Bulla, Tension Pneumothorax, Emphysema, Dyspnea, Smoking, Computed Tomography.
Authors and Affiliations
Dr Gopal Purohit, Dr Isha Garg, Dr C R Choudhary, Dr Sunil Vyas, Dr Srikant Agarwal, Dr Narendra U
Keywords
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