COPD - pulmonary bullae

Case contributed by Sarmad Aslam
Diagnosis almost certain

Presentation

SOB on a background of COPD.

Patient Data

Age: 60 years
Gender: Male
x-ray
Frontal
Frontal
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Info

Large bullae to both superior and mid zones. Severe chronic emphysematous changes are noted at both lung fields. Increased air space opacification right mid and lower zones.

Case Discussion

It can sometimes be challenging to distinguish between bullae and a pneumothorax on a plain film. CT chest is often used in the emergency department to differentiate between pneumothorax and a large bullous before attempting a chest drain insertion.  

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