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Pulmonary Bullous Emphysema


Presentation

  • Operative checklists are included in procedural chapters, and procedures are presented as bulleted to-do lists wherever possible.[books.google.com]
  • Like all materials presented on this site, this paper is presented for information only. It should not be considered medical advice or treatment.[thoracics.org]
  • Patient Presentation A 42-year-old man with chronic obstructive pulmonary disease (COPD) presented to the emergency department (ED) complaining of worsening shortness of breath and respiratory distress.[ctsnet.org]
  • We present a case where a large pulmonary bleb mimics the lung point and therefore inaccurately suggests pneumothorax. [West J Emerg Med. 2015;16(3):447–449.][westjem.com]
Pain
  • Case presentation A 36-year-old Caucasian male patient was admitted to the emergency department with acute onset of left thoracic chest pain. The pain suddenly appeared without physical activity, cough or trauma.[cardiothoracicsurgery.biomedcentral.com]
  • However, patients may sometimes experience difficulty breathing, chronic coughing, chest pain, and other symptoms related to a lack of oxygen in the blood, such as cyanosis.[ic.steadyhealth.com]
  • Thank again everyone When I used to get the pain it was actually the lung going down! When the pain went my breathing was worse - pnumothorax![healthunlocked.com]
  • ., and Christopher Sankey, M.D. 3 Citing Articles A 41-year-old man with a smoking history of 30 pack-years presented with chronic chest pain, dyspnea, and cough.[nejm.org]
  • Individuals with progressive bullous emphysema often experience chest pain, difficulty breathing, chronic coughing, and other debilitating symptoms related to a lack of oxygen in the blood.[webdicine.com]
Physician
  • *Medscape Business of Medicine Academy Survey, September 2015 Learn from Experienced Professionals Courses were developed especially for physicians by business health experts and experienced physicians.[medscape.org]
  • Results can help physicians differentiate emphysema from chronic bronchitis and asthma. Patients with emphysema have lower DLCO results, indicated by a reduced ability to take up oxygen.[medigoo.com]
  • Trained physicians can perform a number of tests to diagnose bullous emphysema. A patient may be asked to blow into a spirometer to measure lung capacity or wear an oximeter on his or her finger to calculate oxygen levels in the blood.[webdicine.com]
  • Email: gilbert.berdine@ttuhsc.edu Author Affiliation - Author Affiliation a a pulmonary physician in the Department of Internal Medicine, Texas Tech University Health Science Center in Lubbock, TX. b a research assistant in the Department of Internal[pulmonarychronicles.com]
  • With proper staff training, medical coding companies help physicians use the right I codes to manage ICD-10 implementation smoothly.[outsourcestrategies.com]
Surgical Procedure
  • The surgical procedure is aimed to provide symptomatic relief and improve lung function.[ic.steadyhealth.com]
  • Categories: Patient education, Surgical procedures Tagged as: bleb resection, blebectomy, blebs, catamenial pneumothorax, chemical pleurodesis, linkedin, patient education and discussion, spontaneous pneumothorax, talc pleurodesis, VATs[thoracics.org]
  • Use of neuromuscular agents sometimes becomes inevitable due to coexisting conditions or in view of certain surgical procedures, which necessitates the use of Intermittent Positive Pressure Ventilation (IPPV).[omicsonline.org]
  • A wide variety of surgical procedures have been proposed, such as local excision of the bullae, plication, stapler resection and lobectomy; videothoracoscopy is reported to be a good alternative to thoracotomy because of its lower invasiveness.[ejcts.oxfordjournals.org]
Cough
  • ., and Christopher Sankey, M.D. 3 Citing Articles A 41-year-old man with a smoking history of 30 pack-years presented with chronic chest pain, dyspnea, and cough.[nejm.org]
  • Shortness of breath and cough are the main symptoms of emphysema. Doctors diagnose COPD and emphysema with lung function tests that measure lung capacity.[medicalnewstoday.com]
  • You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking. If you smoke, quitting can help prevent you from getting the disease.[icdlist.com]
  • A chronic cough is generally the first sign of COPD and as the disease progresses, the airways narrow and usually leads to pulmonary emphysema.[outsourcestrategies.com]
  • Symptoms of COPD The main symptoms of COPD are: increasing breathlessness, particularly when you're active a persistent chesty cough with phlegm – some people may dismiss this as just a "smoker's cough" frequent chest infections persistent wheezing Without[nhs.uk]
Dyspnea
  • The condition has been associated with: Marfan syndrome Ehlers-Danlos syndrome alpha-1 antitrypsin deficiency Affected patients may be asymptomatic or experience hypoxia, severe dyspnea and/or chest pain.[radiopaedia.org]
  • ., and Christopher Sankey, M.D. 3 Citing Articles A 41-year-old man with a smoking history of 30 pack-years presented with chronic chest pain, dyspnea, and cough.[nejm.org]
  • Most patients will present with a combination of dyspnea and chronic cough with expectoration. In later stages, COPD may present with more severe symptoms such as tachypnea, tachycardia, and cyanosis.[amboss.com]
  • He underwent robotic-assisted left apical bullectomy with pleurodesis with improvement of air trapping and hyperinflation and overall improvement in his dyspnea and functional status.[journal.copdfoundation.org]
  • Keywords: Bulla; Emphysema; Dyspnea How to cite this article: Shah N N, Bhargava R, Ahmed Z, Pandey D K, Shameem M, Bachh A A, Akhtar S, Dar K A, Mohsina M. Unilateral bullous emphysema of lung.[lungindia.com]
Pneumonia
  • INTERSTITIAL LUNG DISEASE Honeycomb lung Nonspecific interstitial lung disease (NSIP) Cryptogenic organizing pneumonia Desquamative interstitial pneumonia (DIP) Usual interstitial pneumonia (UIP) (1, 2, 3) Rheumatoid arthritis (1, 2) Sarcoidosis Goodpasture[brown.edu]
  • "Isocal pneumonia ‎ Página 54 - Pulmonary complications of renal transplantation: A survey of patients treated by low-dose immunosuppression - Webb WR. Gamsu G. and Rohlfing BM - Dept. Radiol.. Univ. California Sch. Med..[books.google.es]
  • […] findings Tap on/off image to show/hide findings COPD – infective exacerbation The lungs are hyper-expanded – the diaphragm is flattened and too low There are large areas of black due to bullae A large area of consolidation in the left lung is due to pneumonia[radiologymasterclass.co.uk]
  • […] cm in size when distended o Walls may be formed by pleura, septa, or compressed lung tissue · What a bulla isn’t: other air-containing structures o Pneumatocoele § Thin-walled ( 1mm), gas-filled space in the lung developing in association with acute pneumonia[learningradiology.com]
Pleural Effusion
  • Pneumothorax, emphysema, large bullae, airway obstruction, contralateral pleural effusion and radiographic artifact can also give rise to increased transradiancy of the lung.[cmaj.ca]
  • As discussed in previous articles, pleurodesis can also be used for the treatment of pleural effusions. Sepehripour, Nasir and Shah (2011).[thoracics.org]
  • Chest radiography showed good expansion of the left lung without pneumothorax or residual pleural effusion [Figure 3 ]. The patient ceased tobacco consumption since surgery, supported by Vareniciline (Champix , Pfizer, New York, USA).[cardiothoracicsurgery.biomedcentral.com]
  • The HRCT scan of that patient showed ground-glass opacities interspersed with smooth interlobular septal thickening, resulting in a crazy-paving pattern, associated with bilateral pleural effusion and an enlarged cardiac silhouette.[ncbi.nlm.nih.gov]
Respiratory Insufficiency
  • Indication: patients with COPD grade IV and severe respiratory insufficiency failure that exhibit long-standing pO 2 55 mm Hg, despite administration of optimal medication Oxygen administration is regulated in a way that the pO 2 value rises and pCO 2[amboss.com]
Cyanosis
  • This compares with the hypercapnoea and cyanosis of chronic bronchitis with patients referred to as "blue bloaters". In practice, features of these two syndromes coexist as chronic obstructive pulmonary disease.[radiopaedia.org]
  • However, patients may sometimes experience difficulty breathing, chronic coughing, chest pain, and other symptoms related to a lack of oxygen in the blood, such as cyanosis.[ic.steadyhealth.com]
  • In later stages, COPD may present with more severe symptoms such as tachypnea, tachycardia, and cyanosis.[amboss.com]
  • […] later stages, the person may have: A chronic cough is one of the early signs of emphysema, alongside shortness of breath. frequent lung infections a lot of mucus wheezing reduced appetite and weight loss fatigue blue-tinged lips or fingernail beds, or cyanosis[medicalnewstoday.com]
  • There was no cyanosis, clubbing or peripheral edema. Chest examination results were: non-traumatic, symmetrical with chest accessory muscle of respiration working. Trachea was shifted to right.[lungindia.com]
Heart Failure
  • Prognosis is worse in patients who continue to smoke, are alpha-1-antitrypsin deficient, have low FEV 1 at time of diagnosis, or have other comorbidities (e.g. heart failure, respiratory failure, frequent exacerbations). cystic lung disease: all have[radiopaedia.org]
  • Some diagnostic tests may also be used, to confirm that the patient has emphysema rather than asthma and heart failure. If the patient has never smoked, a test may be carried out to see if the person has an α1-antitrypsin deficiency.[medicalnewstoday.com]
Hypotension
  • […] concentrations Side effects Severe, refractory nausea and vomiting with abdominal pain Tachycardia ; that may degenerate into arrhythmias with severe intoxication Central nervous system involvement ( tremor ;, agitation, insomnia, psychotic symptoms ) Hypotension[amboss.com]
Blister
  • Bulla is a blister more than 5 mm (about 3/16 inch) in diameter with thin walls that is full of fluid or air. Bullae on the pleura, the membrane that covers the lung, are also called blebs.[ic.steadyhealth.com]
  • Defining Traits of Bullous Lung Disease The way Bullous Lung Disease differs from other emphysema illnesses is that the enlarged air-filled spaces in between the alveolar tissue are made up of tiny blisters called "bullae."[healthyliving.azcentral.com]
Arthritis
  • Toxoplasmosis Measles (Rubeola) pneumonia INTERSTITIAL LUNG DISEASE Honeycomb lung Nonspecific interstitial lung disease (NSIP) Cryptogenic organizing pneumonia Desquamative interstitial pneumonia (DIP) Usual interstitial pneumonia (UIP) (1, 2, 3) Rheumatoid arthritis[brown.edu]
Tremor
  • […] e.g. ciprofloxacin, cimetidine ) and variable serum concentrations Side effects Severe, refractory nausea and vomiting with abdominal pain Tachycardia ; that may degenerate into arrhythmias with severe intoxication Central nervous system involvement ( tremor[amboss.com]

Workup

Pleural Effusion
  • Pneumothorax, emphysema, large bullae, airway obstruction, contralateral pleural effusion and radiographic artifact can also give rise to increased transradiancy of the lung.[cmaj.ca]
  • As discussed in previous articles, pleurodesis can also be used for the treatment of pleural effusions. Sepehripour, Nasir and Shah (2011).[thoracics.org]
  • Chest radiography showed good expansion of the left lung without pneumothorax or residual pleural effusion [Figure 3 ]. The patient ceased tobacco consumption since surgery, supported by Vareniciline (Champix , Pfizer, New York, USA).[cardiothoracicsurgery.biomedcentral.com]
  • The HRCT scan of that patient showed ground-glass opacities interspersed with smooth interlobular septal thickening, resulting in a crazy-paving pattern, associated with bilateral pleural effusion and an enlarged cardiac silhouette.[ncbi.nlm.nih.gov]

Treatment

  • Multidisciplinary contributions on medical treatment, radiation oncology, and surgery and anesthesia are included. Highlights include new material on minimally invasive procedures and thoroughly updated diagnostic and treatment information.[books.google.com]
  • Treatments for COPD The damage to the lungs caused by COPD is permanent, but treatment can help slow down the progression of the condition.[nhs.uk]
  • Steroid therapy is also a popular treatment for the lung disease, but is only a starting point for other treatments. All in all, whatever treatment that's prescribed, the first step to overcoming the illness is to stop smoking.[healthyliving.azcentral.com]
  • Some patients with emphysema respond well to steroid therapy, and a steroid treatment trial is usually part of the work-up to find which treatment suits you best.[netdoctor.co.uk]

Prognosis

  • In the final stage of emphysema, when bullae are more likely to appear, the prognosis is often not good.[coughingupblood.net]
  • […] location the size of bullae ranges from 1 to 20 cm in diameter, but most measure 2-8 cm 2 usually asymmetric, with one lung involved to a greater extent than the other the presence of concomitant foci of paraseptal and centrilobular emphysema Treatment and prognosis[radiopaedia.org]
  • Dynamic breathing MRI may have a future role in assessing pulmonary emphysema. 5 Treatment and prognosis Unfortunately, once lung tissue is lost, no regrowth occurs.[radiopaedia.org]
  • Studies show that the BODE Index gives doctors a better idea about your outcome (what they call a “prognosis”) than FEV 1. And they can use those findings to see how well you’ll respond to medications, lung rehab therapy, and other treatments.[webmd.com]
  • The prognosis is poor for each ( 6 ). It is rare that lung cancers are detected via the spontaneous pneumothorax ( 7, 8 ).[jtd.amegroups.com]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • Etiology Exogenous factors Tobacco use ( 90% of cases) Patients with a smoking history of 20–30 pack years have an 80 –90% risk of developing COPD.[amboss.com]
  • […] of Emergency Ultrasound, Manhasset, New York Introduction Case report Discussion ABSTRACT In patients presenting with severe dyspnea, several diagnostic challenges arise in distinguishing the diagnosis of pneumothorax versus several other pulmonary etiologies[westjem.com]
  • These mechanisms share common etiologies, with the most common form of bullous emphysema being associated with chronic smoking.[pulsus.com]

Epidemiology

  • References: [1] Epidemiology References: [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • In addition, we studied some epidemiological aspects of those patients.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology responsible for the natural elimination of giant bullae is not known with certainty. We report a patient who experienced spontaneous sub-total regression of his giant bulla following an infection.[austinpublishinggroup.com]
  • Not considered pathological, but a normal consequence of aging References: [5] [2] [10] Pathophysiology Chronic inflammation of the airways characterized by an increased number of neutrophils, macrophages, and T lymphocytes : Goblet cell proliferation[amboss.com]
  • In, Anaesthesia and Uncommon Diseases: Pathophysiologic and Clinical Correlations. (ed.) Katz, J. & Kadis, L.B. Toronto: Saunders, p. 176.[omicsonline.org]
  • The rationale of EBV use as less invasive procedure for the treatment of GEB is based on the conventional view of the pathophysiology of bullous disease; bulla is defined as a localised area of parenchymal destruction supplied by airways that contain[ejcts.oxfordjournals.org]

Prevention

  • […] best way to prevent emphysema or stop it from getting worse.[medicalnewstoday.com]
  • Treatments include inhalers, oxygen, medications and sometimes surgery to relieve symptoms and prevent complications.[icdlist.com]
  • Preventing COPD COPD is largely a preventable condition. You can significantly reduce your chances of developing it if you avoid smoking.[nhs.uk]
  • Hospital for Sick Children Health A-Z Search a complete list of child health articles expand_more View All Drug A-Z Search a list of articles about medications expand_more View All Learning Hubs Browse a complete list of content groups Healthy Living & Prevention[aboutkidshealth.ca]
  • Performing bullectomy including a small strip of healthy lung tissue might help in the prevention of the above.[cardiothoracicsurgery.biomedcentral.com]

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