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Cocaine-Induced Giant Bullous Emphysema
Steven Douedi1, Vandan D Upadhyaya1, Ishan Patel1
1Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ 07753, USA.
Case Reports in Medicine
|May 27, 2020
Summary
Cocaine abuse can lead to giant bullous emphysema (GBE), a rare condition causing severe lung complications. Early identification and surgical treatment, such as bullectomy with video-assisted thoracic surgery (VATS), can improve patient outcomes.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Toxicology
Background:
- Emphysematous bullae are enlarged airspaces often linked to tobacco use or alpha-1 antitrypsin deficiency.
- Cocaine use is an uncommon cause of emphysematous bullae, typically affecting the lung periphery.
Observation:
- A 50-year-old male with a history of chronic cocaine abuse presented with unresponsiveness and was found to have a massive right pneumothorax.
- Imaging revealed a giant bulla occupying over 95% of the right hemithorax.
Findings:
- Video-assisted thoracic surgery (VATS) identified a giant bulla encasing the right pleural cavity.
- Surgical resection of the bulla and partial pleurodesis led to significant respiratory improvement.
Implications:
- Cocaine use is a rare but critical factor in developing giant bullous emphysema (GBE).
- Early diagnosis and VATS bullectomy are crucial for managing GBE, reducing morbidity and mortality.