Tanigawa S, Koya Y, Hashimoto S, Horie T
First Department of Internal Medicine, Nihon University School of Medicine.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Jun;32(6):587-90.
We experienced a case of progressive giant bulla which ruptured and disappeared on chest roentgenogram. The patient was a 60-year-old male who had been treated with home oxygen therapy for chronic pulmonary emphysema. One year after initiating home oxygen, emphysematous bulla occurred and expanded to become giant bulla which occupied 3/4 of the right hemithorax. Although we attempted to persuade him to undergo surgery for bullectomy, he refused. While being followed as an outpatient, sudden right anterior chest pain occurred, and dyspnea was markedly alleviated at the same time. Chest roentgenogram revealed right pneumothorax and pleural effusion, and the giant bulla subsequently receded. The patient has been stable for the approximately one year period since, without evidence of recurrence. It is rare for giant bullae to cause a pneumothorax. In addition, there are no previous reports in the literature with a clinical course such as that experienced by our patient.
我们遇到一例进行性巨大肺大疱,其破裂后在胸部X线片上消失。患者为一名60岁男性,因慢性肺气肿接受家庭氧疗。开始家庭氧疗一年后,出现肺气肿性肺大疱并扩大成为占据右半胸3/4的巨大肺大疱。尽管我们试图说服他接受肺大疱切除术,但他拒绝了。在门诊随访期间,突然出现右前胸疼痛,同时呼吸困难明显缓解。胸部X线片显示右侧气胸和胸腔积液,随后巨大肺大疱缩小。自那以后,患者在大约一年的时间里病情稳定,没有复发迹象。巨大肺大疱导致气胸的情况很少见。此外,文献中以前没有与我们患者所经历的临床过程类似的报道。