A Case of the Localized Tension Pneumothorax Mimicking Giant Bullae.

Ko, Hyuk; Park, Sung Ho; Kim, Su Hee; Park, Wan; Park, Chong Bin; Kim, Jong Wook; Ryu, Dae Sik; Jung, Bock Hyun

doi:2001.50.6.740

Tuberc Respir Dis > Volume 50(6); 2001 > Article

Case Report

Tuberculosis and Respiratory Diseases 2001;50(6):740-746.
DOI: https://doi.org/10.4046/trd.2001.50.6.740 Published online June 1, 2001.

A Case of the Localized Tension Pneumothorax Mimicking Giant Bullae.

Hyuk Ko, Sung Ho Park, Su Hee Kim, Wan Park, Chong Bin Park, Jong Wook Kim, Dae Sik Ryu, Bock Hyun Jung

Abstract

Background
A 35-year-old woman was admitted to the emergency room with sudden dyspnea that developed one day prior. The initial Chest X-ray showed multiple bullous changes at the right middle and lower lung field and long standing fibrotic tuberculous changes at the right upper lung field. The left lung field was totally collapesed by an fibrotic old tuberculous lesion. In spite of supportive medical care with oxygen therapy after admission, the radiographic lesions were no significant change but the respiratory distress had worsend. The patient suffered respiratory failure and receive mechanical ventilatory support. The HRCT showed a localized tension pneumothorax mimicking multiple giant bullae at the right lower lung field. Immediately after a closed thoracostomy with a 32 French chest tube and air drainage, her vital signs and dyspnea were gradually improved. The patient was successfully weaned from mechanical ventilation after 5 days of mechanical ventilatory support. The patient had receive talc pleurodesis through a chest tube to prevent the recurrence of the life-threatening localized pneumothorax. The patient was discharged without recurrence of the pneumothorax.

Key Words: Tension pneumothorax, Giant bulla, Respiratory failure