Emphysema and Disorders of the Pleural Cavity

  • Edward W. Humphrey
  • Deanne Lawrence McKeown
Part of the Comprehensive Manuals of Surgical Specialties book series (CMSS)


Bullous emphysema is a disorder in which the lungs contain bullae that are not associated with an intrinsic disease of the airways or with pulmonary scarring from a disease such as tuberculosis. For surgical purposes, a bulla is defined as an emphysematous space, not lined by epithelium, with a roof formed by visceral pleura. Most single bullae that occupy less than one-third of a thoracic cavity and that are situated in otherwise normal lungs do not cause symptoms. A large bulla, however, can compress and compromise the function of the rest of the lung. In addition, a bulla can cause a relaxation of the adjacent lung, thereby decreasing the radial tension on airways and causing an increased resistance to airflow. A bulla can become infected; the lung can bleed into a bulla, occasionally causing life-threatening hemoptysis; and a bulla can rupture, producing a pneumothorax.


Pleural Fluid Pleural Cavity Spontaneous Pneumothorax Parietal Pleura Visceral Pleura 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Bartlett JC, Gorbach SL, Thadepalli H, Finegold SM: Bacteriology of empyema. Lancet 1: 338–340, 1974.PubMedCrossRefGoogle Scholar
  2. 2.
    Briselli M, Mark EJ, Dickersin R: Solitary fibrous tumors of the pleura. Cancer 47: 2678–2689, 1981.PubMedCrossRefGoogle Scholar
  3. 3.
    Carlson HA: Acute empyema thoracis. J Thorac Surg 5: 393–433, 1936.Google Scholar
  4. 4.
    Carr DT, Silver AW, Ellis FH Jr: Management of spontaneous pneumothorax: With special reference to prognosis after various kinds of therapy. Proc Mayo Clin 38: 103–109, 1963.Google Scholar
  5. 5.
    Dalton WT, Zolliker AS, McCaughey WTE, Jacques J, Kannerstein M: Localized primary tumors of the pleura. Cancer 44: 1465–1475, 1979.PubMedCrossRefGoogle Scholar
  6. 6.
    Eloesser L: An operation for tuberculous empyema. Surg Gynecol Obstet. 60: 1096–1097, 1935.Google Scholar
  7. 7.
    Finland M, Barnes MW: Changing ecology of acute bacterial empyema: Occur-rence and mortality at Boston City Hospital during twelve selected years from 1935 to 1972. J Infect Dis 137: 274–291, 1978.PubMedCrossRefGoogle Scholar
  8. 8.
    FitzGerald MX, Keelan PJ, Cugell DW, Gaensler EA: Long-term results of surgery for bullous emphysema. J Thorac Cardiovasc Surg. 68: 566–587, 1974.PubMedGoogle Scholar
  9. 9.
    Hillerdal G, Lindgren A: Pleural plaques: Correlation of autopsy findings to radiographic findings and occupational history. Eur J Respir Dis 61: 315–319, 1980.PubMedGoogle Scholar
  10. 10.
    Larrieu AJ, Tyers FO, Williams EH, O’Neil MJ, Derrick JR: Intrapleural instillation of quinacrine for treatment of recurrent spontaneous pneumothorax. Ann Thorac Surg 28: 146–150, 1979.PubMedCrossRefGoogle Scholar
  11. 11.
    Okike N, Bernatz PE, Woolner LB: Localized mesothelioma of the pleura. J Thorac Cardiovasc Surg 75: 363–370, 1978.PubMedGoogle Scholar
  12. 12.
    Ransdell HT Jr, McPherson RC: Management of spontaneous pneumothorax. Arch Surg 87: 1023–1028, 1963.PubMedGoogle Scholar
  13. 13.
    Reid L: The Pathology of Emphysema. Chicago, Year Book, 1967.Google Scholar
  14. 14.
    Robinson JJ: Pleural plaques and splenic capsular sclerosis in adult male autopsies. Arch Path 93: 118–122, 1972.PubMedGoogle Scholar
  15. 15.
    Ryan CJ, Rodgers RF, Unni KK, Hepper NGG: The outcome of patients with pleural effusion of indeterminate cause at thoracotomy. Mayo Clin Proc 56: 145–149, 1981.PubMedGoogle Scholar
  16. 16.
    Seriff NS, Cohen ML, Samuel P, Schulster PL: Chylothorax: Diagnosis by lipoprotein electrophoresis of serum and pleural fluid. Thorax 32: 98–100, 1977.PubMedCrossRefGoogle Scholar
  17. 17.
    Sherman MM, Subramanian V, Berger RL: Management of thoracic empyema. Amer J Surg 133: 474–479, 1977.PubMedCrossRefGoogle Scholar
  18. 18.
    Staats BA, Ellefson RD, Budahn LL, Dines DE, Prakash VBS, Offord K: The lipoprotein profile of chylous and nonchylous pleural effusions. Mayo Clin Proc 55: 700–704, 1980.PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1982

Authors and Affiliations

  • Edward W. Humphrey
    • 1
    • 2
  • Deanne Lawrence McKeown
    • 3
  1. 1.University of MinnesotaUSA
  2. 2.Minneapolis Veterans Administration Medical CenterMinneapolisUSA
  3. 3.SedonaUSA

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