Samanvitha Vengaldas¹*, Soumya Guha² and Monalisa Mishra³

¹Department of Respiratory medicine, Utkal Hospital, Bhubaneshwar, Orissa, India
²Department of Cardio Thoracic and Vascular Surgery, Utkal Hospital, Bhubaneshwar, Orissa, India
³Department of Critical Care Medicine, Utkal Hospital, Bhubaneswar, Orissa, India

*Corresponding Author: Samanvitha Vengaldas, Junior Consultant, Department of Respiratory medicine, Utkal Hospital, Bhubaneshwar, Orissa, India.

Received: October 30, 2023; Published:November 22, 2023

Abstract

Vanishing lung syndrome, also known as Giant Bullous Emphysema, primarily affects young male smokers and is often misdiagnosed as pneumothorax. Detailed radiological workup aids in accurate diagnosis and appropriate management.

Case Report: We present the case of a 25-year-old female who experienced three episodes of hemoptysis and was initially misdiagnosed with right-sided pneumothorax based on clinical and chest radiographic findings. Subsequently, an intercostal drain was inserted on the right side at an outside hospital. Upon persistent right pneumothorax, the patient was referred to our hospital, where further imaging studies revealed giant bullae occupying the right hemithorax. Following comprehensive investigations, the patient underwent Video-Assisted Thoracoscopic Surgery (VATS) and bullectomy.

Conclusion: This case report underscores the significance of clinical and radiological assessment in achieving a timely diagnosis and appropriate management of vanishing lung syndrome, thereby minimizing potential complications.

Keywords: Giant Bullae; Pneumothorax; Video-Assisted Thoracic Surgery; Pulmonary Disease

References

1. Burke R. “Vanishing lungs: a case report of bullous emphysema”. Radiology 28 (1937): 367-371.
2. Roberts L PC., et al. “Vanishing lung syndrome: upper lobe bullous pneumopathy”. Rev Interam Radiol. 12 (1987): 249-255. 
3. Vij AS., et al. “A Rare Case of Vanishing Lung Syndrome”. JAPI (2014): 62.
4. Nur Izat Muhamad., et al. “Vanishing lung syndrome Masquerading as bilateral pneumothorax: A case report”. Respiratory Medicine Case Reports 31 (2020):
5. Khasawneh FA., et al. “Vanishing lung syndrome mistaken for bilateral spontaneous pneumothorax”. Case Reports (2013): bcr2013201016.
6. Siddiqui NA., et al. “Bullous emphysema”. InStatPearls (2021).
7. Yunhee Im., et al. “Vanishing Lung Syndrome”. Baylor University Medical Center Proceedings 29.4 (2016): 399-401.
8. Moustafa MA. “Vanishing Lung”. Open Journal of Thoracic Surgery 12 (2022): 43-50.
9. Based on underlying lung. From Witz JP, Roeslin N: La chirurgie de l’emphyseme bulleux chez l’adulte. Revue Francais de Maladies Respiratoire 8 (1980):
10. Muhamad NI., et al. “Vanishing lung syndrome Masquerading as bilateral pneumothorax: A case report”. Respiratory Medicine Case Reports 31 (2020): 101276.
11. Samanta RP., et al. “Giant Bullous Emphysema Mimicking Spontaneous Pneumothorax”. Cureus11 (2022).
12. Wu XN., et al. “Higher altitude, bigger bulla”. Thorax5 (2018): 495-496.
13. Waitches GM., et al. “Usefulness of the double-wall sign in detecting pneumothorax in patients with giant bullous emphysema”. AJR Am J Roentgenol 174 (2000): 1765-1768.
14. Simon BC and Paolinetti L. “Two cases where bedside ultrasound was able to distinguish pulmonary bleb from pneumothorax”. The Journal of Emergency Medicine2 (2005): 201-205.
15. Waseem M., et al. “Giant bulla mimicking pneumothorax”. The Journal of Emergency Medicine2 (2005): 155-158.
16. Menconi GF., et al. “Treatment by VATS of giant bullous emphysema: results”. European Journal of Cardio-Thoracic Surgery1 (1998): 66-70.
17. Park JH., et al. “A case of bilateral giant bullae in young adult”. Tuberculosis and Respiratory Diseases5 (2013): 222-224.
18. Junior EG., et al. “Giant bullous emphysema mistaken for traumatic pneumothorax”. International Journal of Surgery Case Reports 56 (2019): 50-54.
19. Sood N and Sood N. “A rare case of vanishing lung syndrome”. Case Reports in Pulmonology (2011).
20. Yu-Tzu Tsao and Shih-Wei Lee. “Vanishing lung syndrome”. CMAJ 184 (2012): E977.
21. K Van Bael., et al. “Video-assisted thoracoscopic resection of a giant bulla in vanishing lung syndrome: case report and a short literature review”. Journal of Cardio-Thoracic Surgery 9 (2014): 4.
22. J Wang., et al. “Vanishing lung syndrome”. Canadian Respiratory Journal 21 (2014): 28.
23. W Huang., et al. “Surgery for giant emphysematous bullae: case report and a short literature review”. Journal of Thoracic Disease 6 (2014): E104-E107.
24. JJ Liang., et al. “Vanishing lung syndrome (Idiopathic giant bullous emphysema)”. The American Journal of the Medical Sciences 348 (2014).
25. H Chen., et al. “Giant bullous emphysema in the right middle lobe”. International Journal of Clinical and Experimental Medicine 10 (2015): 19604-19606.
26. Anile M., et al. “Unilateral vanishing lung syndrome”. Thorax 71 (2016): 671-672.
27. P Jaiswal., et al. “The vanishing lung”. Postgraduate Medical Journal (2017).
28. S Saeed and S Gray. “Vanishing lung syndrome in a patient with HIV infection and recurrent pneumothorax”. The Pan African Medical Journal 27 (2017): 141.

Citation

Citation: Samanvitha Vengaldas., et al. “Vanishing Lung Syndrome – What Happens When you Stick a Drain into a Giant Bulla?". Acta Scientific Clinical Case Reports 4.12 (2023): 44-48.

Copyright

Copyright: © 2023 Samanvitha Vengaldas., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.