LARGE EMPHYSEMATOUS BULLAE MIMICKING AS A PNEUMOTHORAX LEADING TO UNNECESSARY CHEST TUBE INSERTION AND IATROGENIC PNEUMOTHORAX

Authors

  • Qalb Khan Well GoodSam Hospital USA
  • Anisa Batool Jinnah Hospital Lahore
  • Muhammad Adnan Haider Allama Iqbal Medical College Lahore
  • Muhammad Hanif Khyber Medical College, Hayatabad Medical Complex Peshawar, Pakistan.
  • Mukarram Jamat Ali King Edward Medical University Lahore
  • Saud Bin Abdul Sattar Staten Island University Hospital Newyork
  • Sheraz Jamal Khan Hayatabad Medical Complex Peshawar

Abstract

Pneumothorax (Pnx) is the presence of air or gas in the pleural space which hinders the lungs to function appropriately. Pneumothorax that presents in the absence of any underlying aetiology is called primary spontaneous pneumothorax (PSP) and on the other hand, it may present as a complication of underlying lung disease which is known as secondary spontaneous pneumothorax (SSP). Iatrogenic Pneumothorax (IP) is a type of SSP and is caused by medical interventional procedures which include transthoracic needle biopsy (24%), sub clavicular catheterization (22%), thoracocentesis (20%), transbronchial biopsy (10%), pleural biopsy (8%) and positive pressure ventilation (7%). We had a 51-year-old patient with a history of COPD/emphysema who presented with respiratory distress. Large bullae were mistaken as pneumothorax, unnecessary Chest Tube Insertion (thoracostomy) was performed resulting in IP. An extensive review of the literature shows there are only a few reported cases of unnecessary thoracotomy and IP in settings of giant bulla mimicking pneumothorax. Iatrogenic Pneumothorax resulting from giant bullae mimicking pneumothorax leading to unnecessary chest tube insertion. Physicians should be aware of such aetiology of pneumothorax as it has been rarely reported in the literature.

Author Biographies

Qalb Khan, Well GoodSam Hospital USA

Hoispitalist, Internal Medicine

Muhammad Hanif, Khyber Medical College, Hayatabad Medical Complex Peshawar, Pakistan.

Postgraduate Resident

Sheraz Jamal Khan, Hayatabad Medical Complex Peshawar

Proffesor and Head of Dept. of Medicine

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Published

2021-07-05