Successful surgical treatment for infectious giant bullae with mediastinal shift: A case report

Giant bulla is defined as a large bulla that occupy over one-third of the thoracic cavity. A 40-yearold Japanese male presented with severe dyspnea and high fever. Radiological examination revealed that several fluid-filled giant bullae had expanded and occupied the majority of the right hemithorax. As a result, mediastinal shift to the contralateral side had occurred. Despite the administration of antibiotic therapy, his condition did not improve. An emergency operation involving resection of the walls of giant bullae and precise suturing of the base of these bullae was performed. After the operation, his condition showed immediate improvement, and the residual right lung was fully expanded. It is essential to make definitive closure of bronchial communication and preserve residual lung parenchyma in cases of rapidly expanding infectious giant bullae.