Successful surgical management of emphysematous giant bullae accompanied by severe bronchial asthma: report of a case.

The surgical treatment of emphysematous lung bullae is usually contraindicated in patients with severe bronchial asthma. However, we recently encountered a patient who required surgery due to the development of respiratory distress despite treatment with bronchodilators and low-dose prednisolone (5 mg/day). During the first operation, bronchospasm occurred with anesthesia. After suppression of the asthmatic symptoms for 2 weeks with high-dose prednisolone (25 mg/day), the giant bullae could be resected safely. Thus, the preoperative resolution of asthma to decrease the probability of an attack is indispensable for such patients.