Vanishing lung syndrome

Abstract

L. M. Darlong ( ) E-mail: lmdarlong@gmail.com It is a rare condition in which emphysematous bulla develop in the lung with the alveolar spaces gradually disintegrating to form large air sac and fi nally all the alveolar air sac combining to form a large or giant bulla which eventually replaces a major part of the lung parenchyma resulting in vanishing lung syndrome, originally described by Burke in 1937 [1]. The term is also used when a bulla occupies more than one-third of the haemithorax. Most of the patients affected are young male, smokers. High-resolution computed tomographic (HRCT) scan is an important tool for assessment [2, 3]. Bullous disorder of the lung is primarily a medical problem, although surgical intervention using video-assisted thoracic surgery (VATS) is benefi cial in reducing chronic and disabling dyspnoea and in the management of specifi c complications such as pneumothorax, infection, haemoptysis or chest pain [1, 2]. Most authors agree that preventive surgery is indicated when the bulla occupies half or more of the haemithorax, compresses the normal lung, or has enlarged over a period of years [1, 4]. The natural history of such untreated giant bulla is usually dead due to respiratory failure [1]. A 20-year-old boy was detected during a routine chest X-ray to have a bullous lung disease on the right side (Fig. 1). There was no history of smoking, chest pain, recurrent cough or fever, he had mild dyspnoea medical research council (MRC) dyspnoea scale of 2. Physical IMAGES IN SURGERY