PUNE: Anything in excess is not good for health, a 32-year-old man in security force learned this, the hard way. The athletic man ruptured a bulla at the apex of the right lung, which caused severe breathlessness and continous coughing after a 30km run in which he exerted himself beyond his limit.
He was admitted in hospital and required a continuous supply of oxygen, but even that did not help. He was referred to chest physician Dr Pankaj Magar at Jehangir Hospital. With his primary tests, he was advised a CT scan of thorax.
Dr Prafulla Tamaskar who operated on the patient said that the CT scan of thorax revealed a bulla at the apex of the right lung.
“A bulla is a permanent, air-filled space within the lung parenchyma that is at least 1 cm in size and has a thin or poorly defined wall. Hence, he was referred to me at Jehangir Specialty Hospital,” said Tamaskar.
As this ruptured bulla was due to heavy exercise schedule, Tamaskar decided to block the air leak in the balloon from the normal lung. Along with anaesthetist Ravindra Kute and Pankaj Magar who helped in the camera work, he performed thoracoscopy at the hospital and identified the ballooned lung over the right apex.
“The surgery was complicated and went on for 3 hours. Key holes were made for the thoracoscopy, then accessed with staples. The abnormal balloon of the right lunch stapled out with tissue from the normal lung at the apex so that the balloon would not give away,” said Dr Tamaskar.
He further said that by expert handling of lung tissue, not allowing the lung to expand, and preventing rupture or puncture of the balloon improved the patient’s condition during the surgery itself.
“The compressed part of lung was fired with endoscopic staplers and was restored to normal. The ballooned part of the lung was excavated, cut and separated from the normal lung. During staplers firing lung tissues, I also checked the leak, which was found closed. Then the patient’s lung was inflated and rechecked, and all parameters were found to be normal,” said Tamaskar.
The patient was then shifted to ICU and then on the fifth day post surgery, he was discharged with a normally functioning lung.
