Intrabullar suction-adhesion in a case of giant bulla of the lung with steroid--department intractable bronchial asthma

We successfully reduced a giant bulla using an intrabullar suction-adhesion method in a case of steroid-dependent intractable bronchial asthma. A 53-year-old woman was hospitalized with an asthma attack, and suffered pneumonia in the area surrounding a giant bulla after remission of two episodes of asthma. After the pneumonia, we found that the giant bulla had increased in volume. It was readily apparent that the bulla should be reduced. At that time a right side pneumothorax occurred by accident, which improved the chest drainage. Immediately after that, we inserted a chest drainage tube directly into the bulla and instilled fibrin glue through the tube into the bulla. Intrabullar suction and bronchial embolization via bronchofiberscopy has been used to patients with inoperable giant bullae of the lung. If intrabullar suction with fibrin glue alone can reduce giant bulla, it would offer another option to patients with inoperable giant bullae without the risk of a surgical procedure.