DOI: 10.11648/j.js.20261404.12 ISSN: 2330-0930

Idiopathic Type I Giant Emphysematous Bulla in a Non-Smoking Female Patient: The First Reported Case from Angola

Maria Nioca, Meloise Tchiloia, Eduardo Kedisobua, Dulcilene Sousa
Show PDF Cite
Introduction: Giant emphysematous bulla is defined as an intrapulmonary air collection occupying 30% or more of a hemithorax. Klingman's classification categorizes bullae according to the quality of the underlying lung parenchyma, with type 1 characterized by a giant bulla surrounded by normal lung. Case Report: Female patient, 54 years old, black woman, from an urban area, with no history of smoking, tuberculosis or chronic obstructive pulmonary disease, with a history of controlled arterial hypertension for approximately 10 years, who started about three months ago with slight progressive dyspnea associated with mild exertion, accompanied by chest discomfort. After normal cardiological examinations, chest radiography revealed increased hyperlucency in the right hemithorax. At the general surgery consultation, the respiratory physical examination demonstrated decreased chest expansion, decreased vocal vibrations and decreased vesicular breath sounds in the right hemithorax, with respiratory rate of 22 breaths/minute. Chest radiography confirmed a type 1 emphysematous bulla according to Klingman's classification, and chest computed tomography confirmed the radiological diagnosis. The patient underwent open bullectomy by the Naclerio and Langer technique (1947). The patient remained hospitalized for 14 days due to a postoperative pleural effusion that was promptly treated, with favorable post-operative course. Discussion: This case is particularly relevant as it represents an idiopathic giant emphysematous bulla in a non-smoker female patient, with no history of tuberculosis or chronic obstructive pulmonary disease, resulting inthe first case report of this pathology in Angola. The epidemiological literature review in Africa revealed few reported cases, predominantly associated with spontaneous pneumothorax or other pulmonary comorbidities. Conclusion: Bullectomy by the Naclerio and Langer technique constitutes an effective surgical approach for the treatment of type 1 giant emphysematous bullae, even in patients without classical risk factors. This case represents the first documented report of this pathology in Angola, contributing to the knowledge of the disease's epidemiology in Africa.

More from our Archive