Bullous Emphysema
Author: V. Dimov, M.D.
Reviewer: S. Randhawa, M.D.
Emphysema is a form of chronic obstructive pulmonary disease (COPD). It is often caused by exposure to tobacco smoke. It may progress to may to bullous emphysema. A bulla is an air space defined as being at least 1cm in diameter, and with a wall less than 1mm thick. The imaging findings in two cases of bullous emphysema are shown below.
Case 1
CXR PA and lateral, close-up view (click to enlarge the images), CXR report, CD4/CD8 count.
CBC, CMP, ABG (click to enlarge the images).
CT of the chest, CT report (click to enlarge the images).
Treatment
Case 2
A giant bulla in a patient with COPD.
A giant bulla in a COPD patient. Close-up of the bulla (click to enlarge the images).
The same bulla two years later (click to enlarge the images).
Summary
Mind map of Chronic Obstructive Pulmonary Disease (COPD)
The average annual rate of decline in FEV1 is 20 to 30 mL in normal persons and double that (50 to 60 mL) in smokers with COPD. Smoking cessation delays decline in FEV1 to near normal levels. Stopping smoking is the most effective method to prevent progression of COPD.
Telling smokers their spirometry "lung age" improves quit rates at 12 months from 6.4% to 13.6% according to a study of 561 UK smokers. The "lung age" concept (the age of the average person who has an FEV1 equal to the patient) was developed in 1985 to help patients understand complex PFTs and to show how they are prematurely aged by smoking.
Unaware of the UK study, the 2007 U.S. Preventive Services Task Force guidelines recommended against screening for COPD using spirometry.
References
Chronic Obstructive Pulmonary Disease (COPD). AllergyCases.org.
Desperate to Cry, Desperate Not To. NYTimes.
Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial. BMJ, doi:10.1136/bmj.39503.582396.25 (published 6 March 2008).
Screening for Chronic Obstructive Pulmonary Disease Using Spirometry: Summary of the Evidence for the U.S. Preventive Services Task Force. Annals of Int Med, 1 April 2008 | Volume 148 Issue 7.
Published: 03/10/2004
Updated: 05/14/2009
Labels: Pulmonology
15 Comments:
My father just passed away with bullous emphysema. He is 46 y/o. He smoked 3 packs/day. He underwent the surgery to remove a bullae from the left lung he lived 1 week on the ventillator. He only had about 1/3 of the right lung, it had a bullae as well.
My mother passed away at the age of 52 from bullous emphysema. She smoked, but not that heavily. She had surgery to remove the bullae, and survived another 5 years.
My husband, age 54,had the "Lung Volume Reduction" surgery 10 years ago. At that time, he quit smoking and started walking to enhance the remaining lung volume. He was given ~5yrs life expectancy. Since that time, he has logged over 12,000 miles as a long-distance hiker. (He remains smoke-free). His mother died when he was 6yo from some type of "lung problems"--we now surmise she also had BE. He remains very active.
My sister is having surgery to remove the bullae in both lungs. She is 41. She's smoked 1 1/2 packs of cigarettes a day since she was 16. She had her first surgery when she was 20 and didn't quit smoking.
My dad is fighting for his life at the hospital because of severe breathing difficulty. He has bullous emphysema. Why is this happening? Smoking. He's been a smoker since age 16, he is now 63, and he looks like a 93 year old man because of smoking. His last words before taking him to he hospital were: "I wish I could have a couple smokes".
i have been told that i have got strong marks in my lung because of bullous in both of my lungs and iam only 33 years old male
My dad is also fighting for his life. He is currently in the hospital. He has COPD, Emphysema, and Bollous Disease. I wonder how long his body will actually last. I hate to see the suffering. He will be 71 years old in July. He has not smoked for 6 years but it all seems to be catching up with him.
I HAVE JUST BEEN RELEASED FROM HOSPITAL AFTER A WEEK STAY AND HAVE BULLOUS EMPHYSEMA IN BOTH LUNGS AND THEY ARE GROWING QUITE RAPIDLY - THEY SAY THEY DO NOT KNOW HOW LONG MY LUNGS WILL HOLD OUT DUE TO MASSIVE SCRRING FROM A PRIOR ACCIDENT
I am a 37 year old female with Bullous Emphysema. It has consumed most of my right lung and it has started in my left lung. They're trying to get me my surgery and told me I'd be better afterward. I've been smoking for 29 years now, I started real young.
My husband will be turning 50 this September 2009. He was diagnosed with this bullous emphysema on 06/16/09. My husband has never smoked a day in his life. Doesn't it seem strange that he would have this disease?
If you don't smoke, don't start! If you smoke now quit now! I started smoking when I was about eleven or twelve years old, at age 29 I had some pains and had x-rays done. My lungs were black and scared. I had a good doctor at a critical care unit that treated me with inhalers. I quit smoking at that time. Now I am 53 years old and diagnosed with bullous emphysema. It sure is hard getting around. I will see my doctors again tomarow and find out what my options are. Live every day the best you can and enjoy what you have, don't let it get you down.
My husband is 35 yrs old and had a pnuemothorax in 3/08. He was in the hospital for 11 days. He had 2 chest tubes because the first one wasn't helping to clear the air out of his chest cavity to allow his lung to re-inflate. He smoked since he was 16 yrs old. About 1 1/2 pks a day. I'm very proud to say that he hasn't smoked since! Although his lungs are severly damaged with the Bullous Emphysema.....he doesn't have any problems with shortness of breath. In fact, the night before this happend, he ran up and down 2 flights of stairs about eight times lugging his drum set from the attic to play a show! Weird huh?
My niece,age 42, just had surgery for BE and has numerous bullae that may require more surgery or treatment later on. She never smoked and cause is unknown.
Re: "My niece had surgery for BE and has numerous bullae that may require more surgery or treatment later on. She never smoked and cause is unknown."
25–45% of patients with COPD have never smoked http://bit.ly/3wAucF
3 billion people, half the worldwide population, are exposed to smoke from biomass fuel compared with 1 billion smokers. Exposure to biomass smoke might be the biggest risk factor for COPD globally rather than cigarette smoke.
http://allergynotes.blogspot.com/2009/09/2545-of-patients-with-copd-have-never.html
I have been diagnosed with bullous paniobular emphysema associated with Marfan's Syndrome. I am on the waiting list for a double lung transplant. I am a 51 year old female.
Post a Comment
<< Home