Unilateral Giant Bullous Emphysema; Vanishing Lung Syndrome

Abstract

Bullous lung disease is an illness characterized by nonfunctional air-filled spaces caused by deterioration of alveolar tissue. Lung diseases such as chronic bronchitis, emphysema, and bronchiolitis are associated with smoking. We aimed to present a case of giant bullous emphysema without any known comorbidity and who was admitted to the clinic with progressive dyspnea in a short time. A 52-years-old male patient was admitted to the clinic with the complaint of increasing dyspnea in the last 3 months. Smoking was 26 pack years, and no chronic disease. Giant bullae with a size of 13x15x20 cm, starting from the right apical and extending posteriorly to the lower lobe fissure, and diffuse emphysematous pathologies were seen in the thorax CT. The patient was operated on for a giant bullous lesion that subtotally contains the upper lobe of the right lung and causes respiratory dysfunction with the compression effect on the middle lobe and lower lobe (resection of the giant bulla was operated by the right thoracotomy). Except for the operation-related pain complaint, no respiratory symptoms were seen. The patient  said with an effort, respiratory distress decreased significantly. No complications were observed, and the patient was discharged on the 6th day of the operation. Vanishing Lung Syndrome is a complication of Chronic Obstructive Pulmonary Disease, and it is defined as idiopathic giant bullous emphysema. This illness defined as giant bulla occupying one-third of the hemithorax, it compresses the mediastinum and lung parenchyma. Differentiating bullous lesions of the lung from pneumothorax is important in the treatment. Surgical treatment is a successful option in symptomatic giant bullae or with compression of lung parenchyma. Bullectomy improves the patient's symptoms, pulmonary function, quality of life, and expansion of the lung parenchyma.