bullae in lungs

bullae in lungs


If you want to get scientific and correct information about lung bullae, we recommend that you read more.

What does bullae of lungs mean?

What do you know about bullae of lung?

Doctors use the word bulla for bags that are full of fluid and are under your skin. What definition of skin lesion does this definition remind you of? Yes, blister


But our purpose in this article is not to talk about skin blisters. We want to go to the bullae of lung or Pulmonary bullae


What is bullae of lung?


What are the causes of pneumonia?

Symptoms of pulmonary bullae


Who should have a bullectomy?

Bullectomy procedures

Postoperative recovery

Complications of bullectomy and treatment of pulmonary edema



What is bullae of lung?

The word “bullae” is a plural word whose singular is bulla

Definition of bulla in lung:

Bags or pockets full of air that are in the lung tissue for various reasons such as

  • emphysema
  • Chronic obstructive pulmonary disease or COPDs


The bulla wall of the lung is indistinguishable

(No discernible wall)

The bullae are more than one to two centimeters in size

Sometimes doctors use another term called pulmonary or lung bleb instead of bags full of lung air that are less than one to two centimeters in size.

Sometimes these two equivalent terms are used

If these airy pockets and sacs inside the lungs cause symptoms for the affected person, they must undergo surgery. Surgery to remove and eliminate the lung bullae is called a bullectomy.

Sometimes the pulmonary bulla grows without treatment and increases in size. The bulla grows and takes up a lot of space inside the lung tissue, putting pressure on the adjacent tissues.

Sometimes the bulla grows to a diameter of twenty centimeters. If the bulla causes more than one-third of the volume of the lungs and around the lungs to be occupied, this bulla is called the giant bulla. It will have negative effects.

In addition, pulmonary bullying can also increase the severity of the underlying disorder, such as aggravating symptoms and accelerating the progression of COPD or chronic obstructive pulmonary disease.



The following statistics are significant in examining the findings of CT scan of the lungs:


Age group 21_30 years:

4/15% has a lung bulb

4% Has pulmonary bullae


Age group 31-40years:

1/32% has a pulmonary bulb ؜

5/3% has pulmonary bullae


Age group 41-50 years:

3/33% ؜has a lung bulb

7/3% has pulmonary bullae

8/14% Simultaneously with pulmonary bulb and bullae


Age group 51-60 years:

25% has Pulmonary bulb

1/7% has pulmonary bullae with bulb


Age group 61-70 years:

2/14% ؜has Pulmonary bulb

6/4% has ؜Pulmonary bullae alone

9% has pulmonary bullae with bulb

It is estimated that about one-third of the world's population with no underlying lung disorder will have at least one bulb or small lung bullae.


What are the causes of pneumonia?

There can be a variety of causes for an air sac to form inside the lungs:

  • Chronic obstructive pulmonary disease or COPD:

This is the most common underlying cause of pulmonary bulla

  • Genetic disorder called:

Alpha one antitrypsin deficiency

And a group of genetic disorders in which there is a defect in the structure of the connective tissues of the body

  • Congenital connective tissue disorder called:

Marfan syndrome

Ehler Danlos syndrome

  • HIV infection
  • Autoimmune disorder of sarcoidosis
  • Cocaine and marijuana users
  • Intravenous drug abusers:

Or in people who are hospitalized and breathing with ventilators


Symptoms of pulmonary bullae

  • Sputum production
  • Cough
  • Shortness of breath
  • Difficult breathing
  • Feeling of tightness in the chest
  • Pressure and heaviness in the chest that intensifies when walking and exercising

Sometimes people with pulmonary bulla report feeling full and heavy in their abdomen, feeling full, and bloating.

In these people, if spirometry or pulmonary function test (PFF) is taken, the result of their lung activity test often indicates severe obstruction and prominent air trapping.

There are different causes and pathways for the formation of pulmonary bulla. If pulmonary bulla develops in the lungs of a person under positive pressure ventilator, by stopping the positive pressure of the device, pulmonary bulla will also be eliminated. In these cases, reducing the positive pressure of the lungs is the key to treat pulmonary bulla



Resection or removing of the bulla is the classic treatment for pulmonary bullae. During this surgery, called a bullectomy, the air sacs of the lungs that have grown and damaged the surrounding tissues by applying pressure are removed.

 if the bulla causes the following symptoms, Bullectomy requires

  • wheezing when breathing
  • Shortness of breath
  • Difficult breathing
  • Chronic and increasing sputum cough
  • Feeling of tightness and heaviness and pressure in the chest
  • General fatigue and weakness due to insufficient oxygen supply


Who should have a bullectomy?

Not all sacs with pulmonary bullae should be operated, and surgery will not be suitable for all patients.

To determine if an infected person can undergo surgery, your doctor will use the results of a chest x-ray, CT scan, angiography, etc. to help determine if a person is a candidate for a bullectomy.


Bullae that occupy more than one-third volume of the lungs, or bullae that prevent the normal dilation of the lungs and interfere with the filling and emptying of the lungs, will require surgery.


The following people are better able to tolerate surgery:

  • Younger age
  • People who do not have airway obstruction
  • People who have only one bulla or only one area of ​​their lungs have bulla


Bullectomy procedures

Bolectomy is performed as follows:

The patient receives general anesthesia.

The surgeon makes a small incision in the armpit on the side of the involved lung, and from that small incision, a wire equipped with a video camera is inserted. Surgery is performed with the help of images.

Surgery can be a bulla resection or a bulla ablation

This is a surgical technique that is not invasive and it is called Video associated thoracoscopic surgery or VAST.

The thorax is the space inside the chest and scopy means seeing, so the concept of VAST is understandable. An operation that is seen inside the thorax through video and surgery is performed


After the removal or ablation of the lung bulla, to remove fluid from the chest, one or more small tubes come out of the chest and out of the initial incision, which is called a drain. And the incision site is sutured. After a few days, when the discharge reaches a certain level, the drains will be removed from the person's body.


Postoperative recovery

General health, general condition, and age determine recovery time. Generally, the person is discharged from the hospital within two to three days and completes recovery after a few weeks of rest at home.


Complications of bullectomy and treatment of pulmonary bullae

  • Air leakage from the pipe is the most common complication
  • Infection
  • Prolonged leakage of discharge from the drain, which is more common in people with underlying lung disorders.
  • Increased pulmonary hypertension
  • Systemic hypertension
  • Fever
  • weight loss


The final word:

Bullectomy is a minimally invasive surgery. It has few risks and complications that will generally improve well. If the surgeon chooses the correct case of a bullectomy and the surgery is successful, you should expect that after a few weeks of the operation, your respiratory function will improve significantly and the severity of the symptoms will decrease and the quality of breathing and life will improve.

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