GIANT BULLA WITH SPONTANEOUS PNEUMOTHORAX

Abstract

During a 15-year period between January 1, 1980 and December 31, 1994, 38 patients were admitted to the department for treatment of giant bulla. Of these 38 patients, 19 (50%) had spontaneous pneumothorax; and 14 had the lesion on the site of giant bulla and 5 on the contralateral site. The incidence of pneumothorax on the site of giant bulla tended to occur in the aged patients. There was no significant difference in the incidence of pneumothorax between existence of smoking habit and non-smoker. However, there were significant differences in the incidence of pneumothorax between upper lobe and another lobes which were the primary site of giant bulla. Of the five patients with contralateral pneumothorax, four were treated with axillary incision for the contralateral pneumothorax prior to operation for the giant bulla, and the remaining one case with conservative drainage because of chronic emphysema. Histopathological examination for the resected specimens showed an increase or interruption of the elastic fiber of the pleura. It is etiologically thought that pneumothorax in these cases might be caused not only by the structure of the pulmonary alveoli but also by weakened pleura.