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espanolLa bulla gigante es una entidad rara que ocurre tipicamente asociada a enfisema, en varones, jovenes y fumadores. La bulla para ser considerada gigante debe ocupar al menos un tercio de un hemitorax y suele aparecer de forma unilateral. Presentamos el caso clinico de una mujer de 55 anos fumadora, que fue remitida desde su centro de salud por alteracion en la radiografia de torax y clinica de disnea, presentando como unico factor de riesgo de interes diabetes mellitus tipo 2. Tras realizar pruebas complementarias oportunas, se observo una bulla gigante voluminosa en el hemitorax derecho ya presente desde al menos el ano 2011, describiendose su evolucion desde entonces. Es una enfermedad progresiva, siendo la causa principal de formacion de bullas gigantes el tabaquismo y clinicamente se manifiesta con disnea y en menor frecuencia hemoptisis, dolor precordial o neumotorax espontaneo. Dentro de las pruebas complementarias fundamentales para su diagnostico destacan las pruebas de imagen como radiografia de torax, demostrando la ocupacion de mas de un 30% de un hemitorax por una bulla, confirmandose posteriormente mediante tomografia axial computarizada. El tratamiento de esta enfermedad en pacientes que presenten disnea grave, neumotorax, dolor, infeccion o hemoptisis, consiste en la bullectomia, la cual presenta un bajo riesgo de mortalidad. EnglishGiant bulla is a rare condition that typically occurs in association with emphysema in males, young persons and smokers. In order to consider the bulla a giant, it should occupy at least one third of the hemothorax and it generally appears unilaterally. We present the clinical case of a 55-year old woman, smoker, who was referred from her health care site due to alteration on the chest x-ray and symptoms of dyspnea, presenting type 2 diabetes mellitus as the only risk factor of interest. After conducting the pertinent complementary tests, a voluminous giant bulla was observed in the right hemothorax, which had already been observed since the year 2011, describing its evolution since then. This is a progressive disease, the main cause of the formation of giant bulla being smoking habit and it is manifested clinically with dyspnea and less frequently hemoptysis, precordial pain or spontaneous pneumothorax. Standing out within the fundamental complementary tests for its diagnosis are imaging tests such as chest X-ray. Occupation of more than 30% of the hemithorax by a bulla was demonstrated, this being subsequently confirmed by computed axial tomography. Treatment of this disease in patients who have severe dyspnea, pneumothorax, pain, infection or hemoptysis consists in bullectomy, which has a low risk of mortality. |
