Challenges in diagnosis and treatment of pneumothorax and giant bullae
https://doi.org/10.18093/0869-0189-2021-31-4-499-504
Abstract
Spontaneous pneumothorax is the most common acute chest disease. Often, giant bullae give the impression of the presence of air in the pleural cavity. Inadequate differential diagnosis leads to vain drainage of the pleural cavity, damage to the lung with its collapse and pneumothorax.
The aim. Analyze diagnostic and tactical mistakes in patients with pulmonary emphysema, which manifests with giant bullae, and outline the ways to prevent complications.
Methods. The analysis of the treatment of 1,636 patients with pulmonary emphysema and its complications undergoing treatment in the thoracic surgical department of the Samara Regional Clinical Hospital named after V.D.Seredavin in the period from 2001 to 2018 is presented.
Results. Giant bulla were diagnosed in 35 (2.1%) patients, 16 of them were hospitalized ungently. In 6 patients, the diagnosis of a giant bulla of the lung was correct, and the patients were referred to the thoracic surgical department. In 10 patients, a giant bulla of the lung was regarded as pneumothorax, and pleural drainage was performed before referral to the thoracic surgical department.
Conclusion. The correct interpretation of the radiological data and comparison with the clinical picture allows avoiding diagnostic errors and the associated danger and complications.
About the Authors
E. A. Korymasov
Federal State Budgetary Educational Institution of Higher Education “Samara State Medical University” of the Ministry of Healthcare of the Russian Federation;
Samara regional clinical hospital named after V.D.Seredavin, Ministry of Healthcare of the Samara Region
Russian Federation
Competing Interests:
Russian Federation
Eugeny A. Korymasov, Doctor of Medicine, Professor, Head of the Surgery Department, Institute of Professional Education, Federal State Budgetary Educational Institution of Higher Education “Samara State Medical University” of the Ministry of Healthcare of the Russian Federation, Head of the Surgery Clinic, Samara regional clinical hospital named after V.D.Seredavin, Ministry of Healthcare of Samara Region
ul. Chapaevskaya 89, Samara, 443099,
ul. Tashkentskaya 159, Samara, 443095
Competing Interests:
no
A. S. Benian
Federal State Budgetary Educational Institution of Higher Education “Samara State Medical University” of the Ministry of Healthcare of the Russian Federation;
Samara regional clinical hospital named after V.D.Seredavin, Ministry of Healthcare of the Samara Region
Russian Federation
Competing Interests:
Russian Federation
Armen S. Benian, Doctor of Medicine, Minister of Healthcare of Samara Region, Associate Professor, Department of Surgery, Institute of Professional Education at the Federal State Budgetary Educational Institution of Higher Education “Samara State Medical University” of the Ministry of Healthcare of the Russian Federation, thoracic surgeon, Samara regional clinical hospital named after V.D.Seredavin, Ministry of Healthcare of Samara Region
ul. Chapaevskaya 89, Samara, 443099,
ul. Tashkentskaya 159, Samara, 443095
Competing Interests:
no
Ju. V. Bogdanova
Federal State Budgetary Educational Institution of Higher Education “Samara State Medical University” of the Ministry of Healthcare of the Russian Federation;
Samara regional clinical hospital named after V.D.Seredavin, Ministry of Healthcare of the Samara Region
Russian Federation
Competing Interests:
Russian Federation
Julia V. Bogdanova, Candidate of Medicine, Associate Professor, Department of Hospital Therapy with courses of polyclinic therapy and transfusion medicine, Federal State Budgetary Educational Institution of Higher Education “Samara State Medical University” of the Ministry of Healthcare of the Russian Federation, Deputy Chief Physician for Medical Affairs, Samara regional clinical hospital named after V.D.Seredavin, Ministry of Healthcare of Samara Region
ul. Chapaevskaya 89, Samara, 443099,
ul. Tashkentskaya 159, Samara, 443095
Competing Interests:
no
K. M. Kolmakova
Samara regional clinical hospital named after V.D.Seredavin, Ministry of Healthcare of the Samara Region
Russian Federation
Competing Interests:
Russian Federation
Ksenia M. Kolmakova, Pulmonologist, Pulmonology Department
ul. Tashkentskaya 159, Samara, 443095
Competing Interests:
no
M. A. Medvedchikov-Ardiia
Federal State Budgetary Educational Institution of Higher Education “Samara State Medical University” of the Ministry of Healthcare of the Russian Federation;
Samara regional clinical hospital named after V.D.Seredavin, Ministry of Healthcare of the Samara Region
Russian Federation
Competing Interests:
Russian Federation
Mikhail A. Medvedchikov-Ardiia, Candidate of Medicine, Assistant of the Surgery Department, Institute of Professional Education at the Federal State Budgetary Educational Institution of Higher Education “Samara State Medical University” of the Ministry of Healthcare of the Russian Federation, thoracic surgeon, Samara regional clinical hospital named after V.D.Seredavin, Ministry of Healthcare of Samara Region
ul.Chapaevskaya 89, Samara, 443099,
ul. Tashkentskaya 159, Samara, 443095
Competing Interests:
no
D. Yu. Konovalova
Samara regional clinical hospital named after V.D.Seredavin, Ministry of Healthcare of the Samara Region
Russian Federation
Competing Interests:
Russian Federation
Darya Yu. Konovalova, Therapist, Thoracic Surgery Department
ul. Tashkentskaya 159, Samara, 443095
Competing Interests:
no
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Review
For citations:
Korymasov E.A., Benian A.S., Bogdanova J.V., Kolmakova K.M., Medvedchikov-Ardiia M.A., Konovalova D.Yu. Challenges in diagnosis and treatment of pneumothorax and giant bullae. PULMONOLOGIYA. 2021;31(4):499-504. (In Russ.) https://doi.org/10.18093/0869-0189-2021-31-4-499-504
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