Can bullae heal on their own? Timely treatment is still needed

Nowadays, people are very prone to bullae. If bullae do not show symptoms, no treatment is required. However, if symptoms appear, surgical treatment is required as it cannot heal itself. If surgical treatment is not performed in time, it will affect the function of the lungs and cause other lesions.

1. For more localized bullae , if the patient has no obvious symptoms, there is no need to rush to consider surgical treatment. Follow-up observation is recommended. In some patients, the bullae may disappear due to obstruction of small bronchioles. Asymptomatic bullae do not require treatment. For patients with chronic bronchitis or emphysema, treatment is mainly focused on the primary lesion. If secondary infection occurs, antibiotics should be used. The bullae that develop after pneumonia in children will usually disappear on their own after the pneumonia is cured. This type of bulla generally does not require surgical treatment.

2. For patients with large pulmonary bullae, which occupy 70% to 100% of the chest cavity on one side and have clinical symptoms but no other pulmonary lesions, surgical removal of the pulmonary bullae can re-expand the compressed lung tissue, increase the breathing area, eliminate intrapulmonary shunt, increase arterial oxygen partial pressure, reduce airway resistance, increase ventilation volume, and improve the patient's symptoms of dyspnea such as chest tightness and shortness of breath.

3. During the operation, as much healthy lung tissue as possible should be preserved, and efforts should be made to only perform bullae resection and suture, or wedge resection of local lung tissue, to avoid unnecessary loss of lung function.

Spontaneous pneumothorax caused by ruptured bullae can be cured by non-surgical treatments such as thoracentesis and closed chest drainage, but recurrent spontaneous pneumothorax should be treated surgically. During the operation, the bullae are ligated or sutured, and 2% iodine can be used to apply to the chest cavity to make the pleura adhere and fix, thus preventing the recurrence of pneumothorax.

The clinical symptoms of patients with hemothorax are sometimes very severe, often with chest pain and dyspnea, as well as a series of manifestations of internal bleeding. Clinically, the changes in the condition should be closely observed, and non-surgical measures such as blood transfusion and thoracentesis should be taken in a short period of time. When there is no obvious improvement in symptoms, thoracotomy should be performed decisively. At this time, there is often heavy active bleeding. Non-surgical treatment and observation for too long often delay the disease, and the prognosis is not as good as surgical hemostasis.

4. The principle of surgical treatment of bullae is to relieve the pressure of the bullae and preserve functional lung tissue as much as possible. Lung resection should not be performed lightly. Common surgical methods are as follows:

(i) Bullectomy: If there is no other lesion in the lung tissue, simple bullectomy should be performed. If blisters are present at the same time, they can be ligated or sutured at their base with silk thread.

(ii) Lobectomy: If the lung tissue in the lobe where the bulla is located has obviously atrophied or has inflammatory lesions and there is no benefit in keeping it, a lobectomy should be performed.