What are the symptoms of pulmonary bullae?

If there are bullae in the lungs, pneumothorax may occur, so we should pay enough attention to it. Many young, tall and thin boys are at risk of pneumothorax, so they should avoid doing overly strenuous exercise in daily life. You should take part in more physical exercises to enhance your lung function, which will be very helpful for disease prevention. So, what disease do bullae indicate?

1. Clinical manifestations

The symptoms of patients with bullae are closely related to the number and size of the bullae and whether there is underlying lung disease. Smaller, fewer, simple bullae may not cause any symptoms and are sometimes discovered incidentally during chest X-ray or CT scans. Large or multiple bullae may cause symptoms such as chest tightness and shortness of breath. Especially giant bullae whose volume exceeds 1/2 of the chest cavity volume on one side, or patients with chronic obstructive pulmonary disease often have obvious symptoms such as chest tightness and shortness of breath. Infection within the bullae may cause symptoms of lung infection. A small number of patients with bullous pulmonary disease experience symptoms such as hemoptysis and chest pain.

2. Diagnostic Basis

1. Chest X-ray examination: It is the most commonly used method for diagnosing bullae. It manifests as thin-walled cavities of varying sizes and numbers within the lung field, with sparse lung texture or only linear shadows in the cavity. X-rays taken during maximal inspiration can determine the number, location, and true size of bullae. There may be compressed and dense lung tissue shadows around the bullae, and sometimes (such as in the case of concurrent infection) fluid levels can be seen in the bulla cavity.

2. Chest CT: It is an effective diagnostic method and more accurate than X-ray. It can clearly display the size, number and range of bullae, observe bullae that are difficult to show on X-rays, clarify the boundary between bullae and lung parenchyma and whether there are other lung diseases, and help to differentiate between pneumothorax and bullae.

Bullae that are large and close to the chest wall need to be differentiated from pneumothorax. Chest X-ray examinations showed increased local lung field translucency, but in patients with pneumothorax, the chest X-ray showed a complete absence of local lung texture, and the lung tissue was compressed toward the hilum, with an arc opposite to that of the bullae. In addition, pneumothorax often presents suddenly and the condition progresses rapidly, while bullae develop more slowly. Chest CT is an effective method for differential diagnosis. When it is difficult to differentiate between giant bullae and pneumothorax, thoracentesis should be performed with caution to avoid puncturing the bullae, causing iatrogenic pneumothorax or even tension pneumothorax.