Eur J Cardiothorac Surg 2003;23:240
© 2003 Elsevier Science NL
Images in cardio-thoracic surgery |
Bullous herniation of the lung through an intercostal drain site
Sridhar Rathinam*,
Francis J. Collins
Regional Department Of Thoracic Surgery, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B5 9SS, UK
Received 23 May 2002;
received in revised form 11 October 2002;
accepted 21 October 2002.
* Corresponding author. Tel.: +44-121-424-1561; fax: +44-121-424-0562
e-mail: srathinam{at}rcsed.ac.uk
Key Words: Bulla • Lung hernia • Chest drain
Intercostal herniation of pulmonary bulla is very rare. A 75-year-old man with emphysema and previous persistent right-sided pneumothorax (Fig. 1)
treated with an apical drain, presented with herniation of a bulla through the apical drain site (Fig. 2)
. It was confirmed as a bulla by chest radiographs and computed tomography scan (the films of which were lost after operation during transfer to parent hospital).
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Fig. 1. Chest radiograph demonstrating a persistent pneumothorax with a bulla in the upper lobe prior to the insertion of the apical chest drain.
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In view of the co-morbidities including emphysema and ischaemic heart disease, the bulla was ligated with a vicryl suture at the neck of the sac under local anaesthesia. There was no air leak, and no form of drainage was used. The patient did well postoperatively.
