• Journal of Veterinary Clinics
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• v.31 no.3
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• pp.241-245
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• 2014

A miniature pinscher and two Maltese dogs were present with dyspnea, and radiography and computed tomography (CT) were performed. All dogs were diagnosed with giant bullous emphysema of the massive, hyperexpanded, and hypoattenuating bulla causing contralateral mediastinal shift. Giant bullous emphysema, the rarest form of bullous lung disease, is defined as a bulla that fills more than 30% of the hemithorax, and multi-detector CT scanning could provide the useful information to confirm a diagnosis of giant bullous emphysema in older dogs. The radiographic and computed tomographic features for giant bullous emphysema were described.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.227-230
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• 1996

Air space disorders are usually considered medical diseases, although some patients with air space disorders can benefit from surgical intervention. Recently we experienced two cases of bullous emphysema. One case is large bilateral apical bullae and the other is infected large bulls of RUL with bullous emphysema. The patient with large bilateral apical bullae underwent simultaneous operation via bilateral thoracotomy and other patient underwent simultaneous bilateral operation via median sternotomy. Postoperatively, the patient with large bilateral apical bullae showed subjective as well as objective improvement and other patient is resulted subjective improvement.

• Journal of Chest Surgery
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• v.9 no.1
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• pp.78-82
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• 1976

Bullous emphysema is usually associated with extensive chronic obliterative pulmonary disease. It is the disease of old age but rare in children or infancy. The bulla in this disease is acquired one. In general the symptoms are due to not the mere presence of the bulla but the extent of underlying lung pathology as emphysema or bronchitis. Occassionally giant bulla of great size may cause symptoms and in this occassion it should be differentiated from other diseases. Especially in children or infancy pneumothorax, congenital pulmonary cyst of lobar obstructive-emphysema should be excluded. Recently we experienced 2 cases of bullous emphysema in infancy with severe respiratory symptoms because of bullae of great size. We felt difficulties in differentiating with other conditions. The purpose of this report is to review our cases thoroughly and enhance considerations of this disease.

• Journal of Chest Surgery
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• v.31 no.6
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• pp.634-637
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• 1998

An unusual placentoid bullous lesion of the lung was reported. The patient was a 27-year- old woman with a 1-week history of chest pain and mild dyspnea. Chest radiographic studies showed multiple huge bullae in right upper lobe and variable-sized bullae in middle and lower lobes with collapse. She underwent right pneumonectomy with preoperative impression of bullous lung disease and emphysema. Histopathologically, the most distinctive features were villous structures within bullous airspace, which resembled placetal villi with degeneration.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.408-413
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• 1996

In most cases of diffuse bullous emphysema and chronic obstructive lung disease, t e risk of surgical treatment is very high. But surgical treatment in selected cases of bullous emphysema with localized involvement of only one side of the lung has suggested safe and good management. So patient selection of surgical treatment Is one of the most important things in management of bullous emphysema. From 1987 to 1992, 11 patients were operated for bullous emphysema with giant bullae at the Department of Thoracic and Cardiovascular Surgery of Chonbuk National University Hospital. Author selected surgical candidates who had progressive dyspnea and symptomatic bullae occupying more than one third of the hemithorax and shifting the trachea and mediastinum to the opposite side of the lung. There were 7 males and 4 females ranged from 19 to 61 years of age. Operative procedures were bullectomy and/or wedge resection in 7 cases, segmentectomy in 2 cases and lobectomy in 2 cases. Symptoms and pulmonary function of all patients were improved six months to three years postoperat vely. There were no postoperative death. We conclude that surgical treatment of bullous emphysema with giant bullae is safe and a good treatment of modality in indicated patients.

• Tuberculosis and Respiratory Diseases
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• v.55 no.2
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• pp.211-216
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• 2003

A 49-year-old male presented with a giant bullous emphysematous lung mimicking a pneumothorax. The initial chest X-ray revealed that the left lung was totally collapsed. A chest tube was inserted at the emergency room, after that an iatrogenic pneumothorax developed. The HRCT showed giant bullous emphysema mimicking a pneumothorax. The pneumothorax spontaneously resolved without special treatment. His bullous lesion had remained unchanged until last follow-up.

• Journal of Chest Surgery
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• v.28 no.11
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• pp.1054-1062
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• 1995

Discrete bullae are a well-recognized feature in patients with generalized emphysematous lung disease. They result in space occupation, expanding preferrentially at the expense of adjacent lung tissue, which has a more normal compliance.The presence of these bullae may aggravate the dyspnea consequent to generalized disease. We underwent operation for emphysematous lung disease using a modification of a technique first described by Monaldi for the drainage of pulmonary cavities after tuberculous infection.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.720-730
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• 1990

The complicated pulmonary emphysema including “Giant bullae” and spontaneous pneumothorax often involve both lungs, and controversy exists concerning which is the more rational means of surgical treatment-bilateral simultaneous operation or two staged operation. We report three cases of the complicated bilateral bullous emphysema and two cases of bilateral spontaneous pneumothorax treated through median sternotomy. We performed the ligation of bullae, bullectomy, cystectomy, wedge resection, and left lower lobectomy through median sternotomy. No technical problems were encountered through this approach, which provided maximum benefit with one operation In conclusions, median sternotomy may be appropriate for resection of emphysematous bullae, specially in a severe COPD patient who may be poorly tolerated the superimposed loss of respiratory function due to incisional pain, because median sternotomy permit bilateral exploration, minimal impairment of pulmonary function, simultaneous restoration of pulmonary function, less incisional pain than routine lateral thoracotomy.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.165-170
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• 1973

The selection and treatment with resection and drainage for patients with emphysematous bullae is discussed with reference to two patients recently. One case with bilateral multiple bullous emphysema resulting tension pneumothorax due to rupture of the bullae on right, 47 year old man with pulmonary tuberculosis history for 16 years, was treated with resection of the bullae on right including upper lobectomy and c!osed rhoracostomy drainage on left for another spontaneous pneumothorax, and result was excellent for 6 month after discharge. Another 53 year old man with giant tension air cysts occupying right whole lung field and shifting mediastinum to the left was treated with right under water sealed closed thoracostomy drainage for 7 days in vain, and resection was not performed for his poor respiratory function and general condition. The most useful preoperarive information was obtained from a study of the plain chest radiogram and the surgical procedure of choice was obliteration of the bullae at thoracotomy.

• Journal of Chest Surgery
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• v.22 no.1
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• pp.10-15
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• 1989

Excision of bullous emphysema or decortication of chronic empyema commonly results in a prolonged air leakage. Prolonged air leakage requires prolonged intercostal drainage, delays recovery, and can be followed complications such as pneumothorax, atelectasis, incomplete expansion of remained lung, secondary infection. To minimize these complications free muscle grafts can be used like a patch to close the opening of visceral pleura and reinforce suture lines without undue tension. From a preliminary study using the latissimus dorsi muscle as a free muscle graft in the rabbit pleural space, viable muscle fibers that seems the result of the process of regeneration can be consistently identified around the degenerating muscle fibers. Voluminous connective tissues and numerous blood vessels are also observed in the peripheral zone. Further studies in that free muscle graft will be sutured with visceral pleura and lung parenchyme will hopefully provide additional information before clinical application.