Abstract
Idiopathic giant bullous emphysema or vanishing lung syndrome is a very rare condition associated with severe forms of emphysema in which the lungs appear to be disappearing on radiograph. It is a progressive condition which usually affects young male smokers and characterised by the presence of giant emphysematous bullae in lungs asymmetrically. The authors hereby describe a rare case of an 18 year old female non smoker, presented with a history of chest pain of two weeks duration. Her chest radiograph showed large bullae in both lungs, more on the left. HRCT thorax confirmed giant bullae in both upper, middle, lingula and apical segments of lower lobes compressing the surrounding lung parenchyma. Diagnosis of idiopathic giant bullous emphysema or vanishing lung syndrome was made based on imaging, for which the patient underwent surgical resection.
Highlights
Emphysematous disease is one of the commonest respiratory diseases encountered in the hospital setting
Idiopathic giant bullous emphysema or vanishing lung syndrome (VLS)) is characterised by giant emphysematous bullae, which occupy at least one-third of the hemithoraxin an asymmetric manner and is mostly seen in the upper lobes
VLS is known as type I bullous disease or primary bullous disease of the lung in which the lungs appear to be disappearing on radiograph[2]
Summary
Emphysematous disease is one of the commonest respiratory diseases encountered in the hospital setting. Idiopathic giant bullous emphysema or vanishing lung syndrome (VLS)) is characterised by giant emphysematous bullae, which occupy at least one-third of the hemithoraxin an asymmetric manner and is mostly seen in the upper lobes. Surgical resection of giant bullae is the treatment of choice[5,6] This is a rare case report of vanishing lung syndrome in an eighteen yearold female without known risk factors as described previously. An 18 year old female non smoker presented with a history of chest pain of two weeks duration and this was her first presentation to a hospital On examination she appeared to be of average built. Laboratory tests including full blood count, complete metabolic profile, cardiac enzymes, Alpha-1 antitrypsin , and electrocardiogram were within normal limits Her chest radiograph showed bullae in both lungs, predominantly upper zones (Figure 1). Our patient underwent successful resection of bullae after careful assessment by the cardiothoracic surgeon and showed no residual symptoms on subsequent follow up
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