Spontaneous pneumothorax. Recent series have noted significant improvements in exercise tolerance as measured by six-minute walk distance and cardiopulmonary exercise testing.
Accessed Nov. Emphysema in the lung surrounding the bulla appears to increase the risk of prolonged air leak. HIV-positive smokers with emphysema have increased concentrations of inflammatory cytokines in the lung microenvironment and upregulated expression of matrix metalloproteinases, proteolytic enzymes involved in development of emphysema.Lung (pulmonary) hernia, bleb or bullae?
In severely symptomatic patients, certain imaging features may suggest a favorable outcome from surgical intervention. Lose weight.
Multiple, small, round, clearly demarcated airspaces in the lung parenchyma, particularly in the absence of surrounding emphysema, should raise suspicion for cystic lung disease e. In some of these cases, lung volume reduction surgery may still be an option. Langerhans cell histiocytosis Lymphangioleiomyomatosis Tuberous sclerosis Lymphocytic interstitial pneumonitis Birt-Hogg-Dube syndrome Pneumocystis jiroveci pneumonia PCP Honeycomb change in idiopathic pulmonary fibrosis Cystic bronchiectasis: Bullectomy is a classic surgical method for an isolated bulla.
Please Note: Because they may enlarge with exercise as a result of air-trapping, bullae may contribute to dynamic hyperinflation, altering chest wall mechanics e. Bullous lung disease can be classified into several major categories based on the condition of the surrounding lung parenchyma: Langerhans cell histiocytosis.
Cystic lung diseases include: Mayo Foundation for Medical Education and Research; 2009. Secondary spontaneous pneumothorax in adults. If blebs become larger or come together to form a larger cyst, they are called bulla. As with any thoracic surgery, advanced age and severe comorbid disease increase risks of surgery and may tip risk-benefit ratio against surgery.
The tube will be removed if no leak is apparent, and the patient will be sent home. Long-term smoking also greatly increases the risk of developing primary spontaneous pneumothorax in both men and women. One theory is that the altered folliculin protein may trigger inflammation within the lung tissue that could alter and damage the tissue, causing blebs. Smoking cessation is the most important intervention to slow the progression of bullous lung disease.
Symptoms are typically insidious, but sudden and severe dyspnea or chest pain in a patient with bullous lung disease should raise suspicion for pneumothorax due to a ruptured bulla or bleb. Regarding the bullectomy itself, it has been performed successfully using several surgical approaches.
Symptomatic patients often experience clinically significant improvements in symptom control and exercise tolerance from usual COPD treatment such as bronchodilators, inhaled corticosteroids, and oxygen as needed, and pulmonary rehabilitation. Cavitary lung disease: Am J Hum Genet. Related Symptom Checker Shortness of breath.