Abstract
A 13-year-old female child was referred to our hospital complaining of fatigability and shortness of breath. She had had occasional chest pain at exercise since her elementary school ages and became to feel fatigability and shortness of breath after entrance into a junior high school when she started club activities. Chest X-ray and CT demonstrated an emphysematous giant bulla of the right upper lobe that had occupied half of the thoracic cavity. The segmental bronchus of the right upper lobe was compressed from the outside. In the thoracoscope-assisted surgery, dilated blood vessels existed on the surface of a large thin-wall cystic lesion. After removing the cyst wall, air leakage was found from three points on the lung parenchyma by a water seal test. The cyst base was closed by multiple imbricating mattress sutures. The patient was uneventfully discharged on the 7th day after the surgery. Histology revealed the cyst wall to be composed of fibrous tissue with slight infiltration of inflammatory cells. There was no airway epithelium lining inside the cyst. Therefore, we concluded that the giant bulla increased in size with the same check valve mechanism as adult patients.
