Presentation
Sudden dyspnea.
Patient Data
Left massive hypertensive pneumothorax with complete atelectasis of the left lung.
Left spontaneous pneumothorax due to ruptured apical blebs. CT images through the upper apices of the lungs show large left apical multilocular bleb. Note the chest tube in place on the left. Small blebs are also present in the right apical lung.
Case Discussion
A pulmonary bleb is a small collection of air between the lung and the outer surface of the lung (visceral pleura) usually found in the upper lobe of the lung.
When a bleb ruptures, the air escapes into the chest cavity causing a pneumothorax.
The detection of blebs with CT scan has good sensitivity and is essential to determine the indication of pulmonary surgery to prevent the recurrence of pneumothorax.
Treatment: bilateral therapeutic and preventive blebs resection from VATS.
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