Lung bullae

Pathology and pathogenesis of pulmonary bullous general secondary to the small bronchial inflammatory disease, such as pneumonia, emphysema and tuberculosis, The most common clinical coexist with emphysema. Because of the inflammatory lesions, small bronchial mucosal edema, resulting in the lumen of obstruction, have a valve, alveolar air and can be difficult to discharge, and therefore increased alveolar pressure. Under normal circumstances, there is collateral alveolar breath, although some of bronchial obstruction, pulmonary pressure is not too high. But in a state of inflammation, lung tissue is damaged, the collateral alveolar breath away, alveolar septal gradually due to the increased pressure within the foam broke down, is having a tremendous balloon containing cavity, clinically known as pulmonary bullous. Bullous lung secondary to pneumonia or pulmonary abscess were more common in infants, the single also have its effect. Secondary to tuberculosis were mostly single hair, no significant emphysema also exist. Secondary to pulmonary emphysema, often multiple, with the exception of large bubbles, accompanied most small bubbles. Bullous lung wall of very thin, flat from alveolar epithelial cells, it may only fiber membrane. Bullous constantly expanding, occupies the side of the chest, oppression adjacent lung tissue, or even push the contralateral mediastinum, the shape of tension pneumothorax. If increased pressure within the alveolar to the pleural cavity burst, the bubble formation, part of the wall shall be composed of pleura, This form of foam called the pleura great bubble. Another big bubble volume smaller, often marginalized lobe formation beads, clinically known as pulmonary vesicles, often with great big bubbles coexist. The large foam vesicles, if broken, will have a so-called spontaneous pneumothorax. Clinical manifestations of pulmonary bullous such as single and little tension, its symptoms may not be significant. But if the same time has extensive emphysema or multiple large bubbles, we would often cough, chest tightness, shortness of breath and other symptoms. Great bullous lung, the higher tension within the bubble, many different degrees of difficulty in breathing, some patients lost labor, even action is restricted. Severe emphysema with lung bullae, can induce pulmonary heart disease, or aggravated pulmonary heart disease development. In with spontaneous pneumothorax, then a sudden chest pain, dyspnea, in a serious tension pneumothorax cases, corresponding increase dyspnea, cyanosis may arise. Diagnosis of lung bullae in the diagnosis depends primarily on X-ray examination, but could not ignore history, symptoms and signs. Have a long history of chronic cough or a history of bronchial asthma, a marked shortness of breath or breathing difficulties, should consider pulmonary bullous exist and should be further checks. Children with pneumonia suddenly apparent breathing difficulties, should consider the possible pulmonary bullous. Check bullous lung ipsilateral or spontaneous delivery is drum sound, breath sounds significantly decreased or disappeared. X-ray examination revealed pulmonary excessive transmission, see a huge cavity thin, occupants of a lung or a lobe, or even the whole side of the chest, with no markings or only some of the hilum of video cords. Some of the single, some multiple, and in some cases both occurred. Bullous lung often spontaneous pneumothorax and the need for differential diagnosis. If the existence of emphysema, pulmonary emphysema were the X-ray, such as translucent as a whole lung tissue was generally increased, downward movement of the diaphragm and other obvious signs. For more limited treatment of lung bullae, patients without obvious symptoms, there is no need to hurry to consider surgical treatment, follow-up observation, Some patients may be due to the elimination of small airway obstruction, pulmonary bullous may also disappear. Pediatric pneumonia arising from the lung bullae, the cure pneumonia after more may disappear. Such pulmonary bullous generally do not need surgical treatment. Bullous lung than exist for a long time, which obviously affected the respiratory function, should be surgical treatment. The pulmonary emphysema bullous themselves are less likely to disappear, pulmonary bullous lung oppression can increase the financial burden of patients. it should be as early as surgical resection of bullous to the lifting of the oppression of lung tissue, thereby improving respiratory function. The simultaneous existence of pulmonary heart disease patients is not a contraindication for surgery, the hospital had three cases of bullous lung patients while pulmonary heart disease, surgical resection of bullous lung, heart failure soon improved, Respiratory function has also been significantly improved. Bullous lung surgical treatment principle is not only to relieve the pressure of big bubble, but also to preserve as much as possible of functional lung tissue, an appetite for lung resection. Commonly used surgical methods are as follows : (a) bullous resection : If no other lung diseases, should be used only with great bubbles. Bullous first incision, for the purpose of tracheal compression lung full expansion, clearly the extent of the lesion, bullous wall resection, However, a suitable portion of the edge of the bubble for suture cavity, covered packets were assembled for export. Pleural for excessive expansion and integration of alveolar, showing diffuse alveolar air leakage, if the bronchial small leakage, fine silk thread used to be repaired, then fine silk thread or fine catgut from the cavity wall to the end of the 1950s and suture, Then the bubble has retained wall coverage of marginal pulmonary surfactant and use string tight suture to prevent leakage of small bronchus. The same time there is a small bubble, its base can be used to be silk thread or suture ligation. (2) lobectomy : If bullous lung lobe where the organization has significantly shrink or inflammatory lesions,'s unhelpful to stay, should make lobectomy. In the bubble resection, the current number of advocates in the pleural cavity dispersed into talcum powder to produce pleurodesis prevention of postoperative pneumothorax, pleural may promote the formation of collateral circulation. the latter may help to strengthen the lung tissue nutrition.