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Herniation of emphysematous bulla through a chest tube site
IMAGES IN CARDIOTHORACIC SURGERY
Herniation of Emphysematous Bulla Through a Chest Tube Site Jiri A. Konecny, DO, Michael A. Grosso, MD, Javier Fernandez, MD, David Murphy, MD, and Lynn B. McGrath, MD Department of Surgery, Deborah Heart and Lung Center, Browns Mills, New Jersey
A
69-year-old male cigarette smoker with bullous emphysema presented with progressive dyspnea, chest pain, and hemoptysis. Chest radiograph revealed 100% right-sided pneumothorax. A 28 F chest tube was inserted through the fifth intercostal space in the anterior axillary line. The chest tube was removed in 36 hours.
Address reprint requests to Dr Konecny, Deborah Heart and Lung Center, 200 Trenton Rd, Browns Mills, NJ 08015.
© 1999 by The Society of Thoracic Surgeons Published by Elsevier Science Inc
The following day, the patient had an episode of coughing, which resulted in sudden protrusion of a 9-cm bulla through the chest tube site (Fig 1). The patient remained comfortable and afebrile. Computed tomography of the chest confirmed severe bullous disease, herniated bulla, and compression atelectasis in lower lung fields (Fig 2). The patient underwent emergency bullectomy through antero-lateral thoracotomy. Surgical findings revealed the eviscerated bulla to be a part of the right lower lobe. The patient was discharged home on the ninth postoperative day.
Ann Thorac Surg 1999;68:584 • 0003-4975/99/$20.00 PII S0003-4975(99)00632-3
Herniation of Emphysematous Bulla Through a Chest Tube Site Jiri A. Konecny, DO, Michael A. Grosso, MD, Javier Fernandez, MD, David Murphy, MD, and Lynn B. McGrath, MD Department of Surgery, Deborah Heart and Lung Center, Browns Mills, New Jersey
A
69-year-old male cigarette smoker with bullous emphysema presented with progressive dyspnea, chest pain, and hemoptysis. Chest radiograph revealed 100% right-sided pneumothorax. A 28 F chest tube was inserted through the fifth intercostal space in the anterior axillary line. The chest tube was removed in 36 hours.
Address reprint requests to Dr Konecny, Deborah Heart and Lung Center, 200 Trenton Rd, Browns Mills, NJ 08015.
© 1999 by The Society of Thoracic Surgeons Published by Elsevier Science Inc
The following day, the patient had an episode of coughing, which resulted in sudden protrusion of a 9-cm bulla through the chest tube site (Fig 1). The patient remained comfortable and afebrile. Computed tomography of the chest confirmed severe bullous disease, herniated bulla, and compression atelectasis in lower lung fields (Fig 2). The patient underwent emergency bullectomy through antero-lateral thoracotomy. Surgical findings revealed the eviscerated bulla to be a part of the right lower lobe. The patient was discharged home on the ninth postoperative day.
Ann Thorac Surg 1999;68:584 • 0003-4975/99/$20.00 PII S0003-4975(99)00632-3