Background: Distinguishing between a bulla and pneumothorax can sometimes be difficult especially in the absence of preexisting lung disease, leading to inappropriate intervention.
Case Presentation: We report the case of a well 32-year-old male who presented with a year’s history of insidious onset breathlessness. A routine chest radiograph was thought to show a large pneumothorax. He had chest drains placed with no radiological improvement. A video-assisted thoracic surgery procedure revealed a giant bulla.
Conclusion: This case highlights the importance of correlating clinical assessment with radiological findings. Early Computerised Tomography (CT) imaging should be considered prior to pleural intervention in clinically stable patients.
Key words: Pneumothorax, bulla, chest drain, chest X-Ray, vanishing lung syndrome.
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