Introduction:
Human beings have a pair of lungs that consist of numerous tiny air sacs known as alveoli. Emphysema is a clinical condition in which the alveoli are damaged, and lung tissue is destroyed. Bullous emphysema (BE) is characterized by damaged alveoli that form exceptionally huge air spaces, commonly within the uppermost part of the lung.
BE is diagnosed during a radiographic analysis of chest X-rays, including a chest Computed tomography (CT) scan. The CT scan shows the presence of bullae, typically measuring one centimeter or more in size, and the pockets of air give the appearance of a disappearing lung. Hence, it has also been termed vanishing lung syndrome by radiographers but is not used by clinicians typically.
How Is It Caused?
The two main known causative agents for BE are tobacco smoking and alpha-1 antitrypsin deficiency. Various other conditions can also contribute to the development of bullae in the lung, which are as follows:
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Human immunodeficiency virus (HIV) infection.
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Marfan syndrome.
BE is a serious condition that may lead to permanent changes in the lung. The enlarged air spaces in this condition are not capable of exchanging oxygen and carbon dioxide. This leads to a decreased amount of oxygen available to the body.
The incidence of BE is more commonly seen in adults over the age of 30 years worldwide. Almost 12 percent of them are affected by it. People diagnosed with emphysema have an increased risk of developing collapsed lungs, known as pneumothorax. This condition can prove to be fatal as pneumothorax may further decrease the amount of oxygen available in the body.
What Are the Symptoms of BE?
A person suffering from BE may have one or more small bullae or even a giant bulla, which can measure up to 20 centimeters.
This giant bulla can cause many symptoms as the following:
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Pressure in the chest.
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Shortness of breath.
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Difficulty in breathing.
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Soreness in the chest.
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Tiredness.
When examined, doctor may look for the following symptoms:
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A chest shaped like a barrel.
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Fingers clubbed.
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An intense heartbeat that results from pulmonary hypertension.
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Edema, or swelling.
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Wheezing.
How Can It Be Diagnosed?
Initially, the physician will ask certain questions about the signs and symptoms the patient is facing, followed by a physical examination. To confirm the diagnosis, a doctor will use certain imaging tests like chest X-rays and CT scans.
1. Chest X-ray:
It is a simple, non-invasive test that gives detailed images of the lungs and is the most commonly used imaging test for the analysis of lung diseases. A chest X-ray can be used to determine features of general bullae, like size and location.
2. CT Scan:
CT scans of the chest are known to be more sensitive and specific than X-rays in the detection of emphysema. However, a CT scan is not always necessary to diagnose Chronic obstructive pulmonary disease (COPD).
The physician may advise a CT scan in the following scenarios-
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An individual has a change in symptoms suggesting complications of COPD like pneumonia.
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If a person is diagnosed with an alternative disease like pulmonary embolism.
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If a person is indicative of lung cancer from a screening test.
3. Pulmonary Function Tests:
A Pulmonary function test (PFT) is a test used to check the functioning of the lungs. They are noninvasive tests.
They are used to measure the following:
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Lung capacity.
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Lung volume.
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Exchange of gases.
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Flow rates.
All these parameters help in diagnosing as well as planning the treatment for the patient.
How Can It Be Treated?
A doctor will usually prescribe inhalation drugs to help with symptoms when treating BE.Reliable Source for COPD. They function by:
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Reducing airway inflammation and opening the airways to help breathe in and out of the lungs
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Reducing dyspnea
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If a person's oxygen saturation is low, they might also be given oxygen.
In certain cases, surgery may be necessary if the bullae are big or if there are complications like:
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A collapsed lung, or pneumothorax.
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Coughing up blood from the lungs or airways is known medically as hemoptysis.
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An infection.
During surgery, the entire bullae may be removed—a procedure known as a bullectomy. They might also cut out a section of the tissue that is most affected by the emphysema. Surgeons call the latter procedure "lung volume reduction surgery." When someone has significant COPD-related lung damage, this surgery helps them breathe easier. As an alternative, doctors could advise patients with severe emphysema to have a bronchoscopic lung volume reduction, a minimally invasive operation.
What Are the Other Types of Emphysema?
Emphysema is a serious lung disease that can leave a person experiencing shortness of breath. It can remain life-long and has various types other than bullous emphysema which can be diagnosed using chest X-rays.
These types have been mentioned below:
1. Paraseptal:
Paraseptal emphysema is also called distal acinar emphysema. It is emphysema which mainly affects the upper portion of the lungs. This condition can progress into BE. It can lead to certain damage, which can form empty spaces in the lung tissue over time. If these spaces become too big, the individuals may be at risk of developing collapsed lungs.
2. Panlobular:
Panlobular emphysema is known to affect the entire lung or the lower lobes.
The causes for this condition can be the following:
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Aging.
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Smoking tobacco is a common causative factor of emphysema.
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The deficiency of alpha-1 antitrypsin is an inherited condition.
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Ritalin Lung- These are the changes in the lung caused due to injecting talc-containing methylphenidate like Ritalin.
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Obliterative Bronchiolitis- Inflammatory condition of lungs.
3. Subcutaneous:
Subcutaneous emphysema occurs when the air reaches underneath the skin. Most commonly, it is known to affect the skin on the chest or neck, but it can also affect various other parts of the body. This type of emphysema differs from the various other types mentioned in this article. Also, smoking is not a causative agent for this condition.
Conclusion:
Bullous emphysema is a condition affecting the lung which can cause symptoms related to lung dysfunction. It can be diagnosed with the help of radiographs. Physicians typically use chest imaging methods like X-rays or CT scans to diagnose BE, a kind of emphysema. These examinations may show significant bullae or air pockets in one or both lungs. In order to help with breathing issues, BE therapies usually involve addressing and managing COPD. Surgeons may also advise surgery to remove symptomatic large bullae. A specialist can be consulted online through online medical platforms to know more about this condition.
