There are various definitions of giant bullae: a large bulla occupying at least one third of a hemithorax, or at least one half, or > 10 cm in diameter. Giant bullae do not contribute to gas exchange, as occupying a large space within the thorax results in increased work of breathing and eventually exercise limitation and dyspnea.The standard management of a giant bulla is not yet established. Patients with giant bulla are mostly heavy smokers, elderly, and complicated with chronic obstructive pulmonary disease. Therefore, it is common that the patients are not ideal candidates for surgical intervention.
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