Boudabous Safa, Bouacida Imen, Yahia Mouna Ben Hadj, Zribi Hazem, Marghli Adel
Department of Thoracic Surgery, Abderrahmane Mami Hospital-Ariana, Tunisia.
Department of Thoracic Surgery, Abderrahmane Mami Hospital-Ariana, Tunisia.
Int J Surg Case Rep. 2025 Jan;126:110718. doi: 10.1016/j.ijscr.2024.110718. Epub 2024 Dec 8.
An emphysema bulla is defined as a distension greater than 1 cm of an airspace beyond the terminal bronchioles. Infection of an emphysema bulla is a common and serious complication of chronic obstructive pulmonary disease (COPD), which can lead to significant morbidity. Surgical intervention may be necessary in severe cases to prevent further complications.
We present a case series of seven male patients with an average age of 46 years, all diagnosed with infected emphysema bullae. The predominant clinical symptom was chest pain, often accompanied by fever and chills. Chest X-rays revealed hyperclarity occupying more than two-thirds of the pulmonary field in all patients. A follow-up CT scan confirmed the presence of large bullous emphysema. All patients received antibiotics for one to two weeks before surgery.
Surgical management was performed in all cases due to the severity of the infection and the size of the bullae. Postoperative recovery was uneventful in four patients. Two patients experienced prolonged air leaks requiring extended chest drainage, and one patient developed atelectasis, which resolved favorably with conservative management. This case series highlights the role of timely surgical intervention in the treatment of infected emphysema bullae and the associated postoperative complications.
Infected emphysema bullae represent a significant complication in patients with COPD. Surgical intervention, alongside antibiotic therapy, offers a safe and effective treatment option, resulting in favorable outcomes for most patients. Prompt diagnosis and management are crucial to avoiding severe complications.
肺气肿大疱被定义为终末细支气管远端气腔直径大于1厘米的扩张。肺气肿大疱感染是慢性阻塞性肺疾病（COPD）常见且严重的并发症，可导致显著的发病率。在严重情况下可能需要手术干预以预防进一步的并发症。
我们报告了一组7例男性患者的病例系列，平均年龄46岁，均被诊断为感染性肺气肿大疱。主要临床症状为胸痛，常伴有发热和寒战。胸部X线显示所有患者肺部透亮度增加，占肺野的三分之二以上。随访CT扫描证实存在大疱性肺气肿。所有患者在手术前接受了一到两周的抗生素治疗。
由于感染的严重程度和大疱的大小，所有病例均进行了手术治疗。4例患者术后恢复顺利。2例患者出现持续漏气，需要延长胸腔引流时间，1例患者发生肺不张，经保守治疗后好转。该病例系列强调了及时手术干预在治疗感染性肺气肿大疱及其相关术后并发症中的作用。
感染性肺气肿大疱是COPD患者的一种重要并发症。手术干预与抗生素治疗相结合，提供了一种安全有效的治疗选择，大多数患者预后良好。及时诊断和处理对于避免严重并发症至关重要。
