Hemorrhage from an enlarged emphysematous bulla during commercial air travel.
Pulmonary bullae are a common late complication in patients with emphysema. Non-communicating emphysematous bullae may expand during air travel when the ambient pressure is reduced, resulting in various forms of barotrauma including pneumothorax and air embolism. We report a 62-yr-old man with emphysema who developed hemoptysis during international commercial air travel. CT scan of the chest obtained after the travel showed air-fluid level in an enlarged bulla. He underwent resection of the bulla and had a full recovery. This is a unique presentation of stretch injury of a bulla as a form of pulmonary barotrauma occurring during commercial air travel. With the most recent ruling by the Federal Aviation Administration to allow patients with advanced chronic obstructive lung disease to travel by air with their own supplemental oxygen devices, physicians need to be aware of this type of pulmonary barotrauma and properly advise such patients who are planning to travel by air.
Chen
Chien-Wen
CW
Department of Critical Care Medicine, Tri-Service General Hospital Taipei, Taiwan, Rep of China.
Perng
Wann-Cherng
WC
Li
Min-Hui
MH
Yan
Horng-Chin
HC
Wu
Chin-Pyng
CP
D000337:Aerospace Medicine; D000399:Air Pressure; D006469:Hemoptysis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D012129:Respiratory Function Tests; D014195:Travel