Development of a giant bulla after lung volume reduction surgery

Lung volume reduction surgery (LVRS) is being evaluated in the treatment of emphysema. The proposed mechanisms of improvement are increased elastic re coil of the lung and improved mechanical efficiency of the muscles of respi ration. We report a unique patient with emphysema who developed a giant bul la 3 years subsequent to LVRS. The patient underwent extensive evaluation, including measurements of lung mechanics. Bullectomy was performed, but it was unsuccessful. Although the mechanisms behind the development of giant b ullous disease remain speculative, heterogeneous improvement in elastic rec oil following LVRS may be one of the responsible mechanisms.