PMC6702430_01
A. Preoperative chest X-ray; 1B Chest-CT showing a giant bulla on the left side, displacing the mediastinum on the right. Arrows indicate the double-wall signs.
gr1.jpg
PMC6702430_01_gr1.jpg
fig0005
The chest radiography showed progressive enlargement of the bulla in the left lung of over 10 years (Fig. 1A). A CT scan obtained during the current admission revealed a giant bulla with a diameter of 10.5 x 11 cm in the left lobe, causing significant compression of fairly normal lung parenchyma (Fig. 1B).
A-B. Dense pleural adherences visible on chest CT (arrows).
gr2.jpg
PMC6702430_01_gr2.jpg
fig0010
The patient underwent surgical resection of the bulla firstly by VATS approach, converted after 30 min into a left thoracotomy for dense pleural adhesions (Fig. 2A and B).
A. Surgical isolation of the giant bulla. The bulla measured 11 cm in length. 3B Six-day postoperative chest X-ray.
gr3.jpg
PMC6702430_01_gr3.jpg
fig0015
Bullectomy section was performed by GIA Stapler-75 and reinforced with interrupted sutures of Vycril 2/0 (Fig. 3A). The follow-up chest X-ray showed no pneumothorax, and the patient was discharged in good general clinical condition on the sixth day (Fig. 3B).