Abstract
We report a case of right-sided spontaneous pneumothorax following herniation of an emphysematous bulla into the left anterior mediastinum. An 81-year-old man was brought into our emergency department by ambulance because of the sudden onset of right-sided chest pain and dyspnea. When he was seen at our hospital, he revealed decreased breath sounds in the right lung. He was diagnosed with right-sided spontaneous pneumothorax based on a chest plain X-ray film, and chest drainage was initiated. Chest computed tomography scan demonstrated a bulla in the right upper lobe extending into the contralateral hemithorax. As his pulmonary fistula persisted even 5th day after drainage, surgical bullectomy was performed using an endoscopic stapling device. He was discharged from our hospital on the 7th postoperative day, and he is doing well without recurrence as of 6 months after the operation. We emphasize that emphysematous bullae may herniate into the mediastinum.
