[Clinical Picture] Vanishing lung syndrome: giant bullous emphysema

A 44-year-old man with a 17-year history of tobacco and cannabis use presented to the emergency department with acute dyspnoea and left-sided pleuritic chest pain. He had no other medical conditions and took no regular medications. On examination he was thin and hypoxic, with a silent, hyper-resonant left hemithorax. Chest radiograph showed a large left upper lobe bulla (figure), and an incidental air rifle pellet. He was given pulmonary rehabilitation, started on regular inhaled therapy with regular tiotropium and budesonide-formoterol and salbutamol as required, and given smoking cessation support.
Source: LANCET - Category: General Medicine Authors: Tags: Clinical Picture Source Type: research