TY  - CHAP
M1  - Book, Section
TI  - Resection of Blebs, Bullae, and Giant Bullae
A1  - Sonett, Joshua R.
A1  - Bromberger, Bianca
A2  - Sugarbaker, David J.
A2  - Bueno, Raphael
A2  - Burt, Bryan M.
A2  - Groth, Shawn S.
A2  - Loor, Gabriel
A2  - Wolf, Andrea S.
A2  - Williams, Marcia
A2  - Adams, Ann
PY  - 2020
T2  - Sugarbaker’s Adult Chest Surgery, 3e
AB  - The  pulmonary  bleb  is  a  small  subpleural  collection  of  air  located  within  the  layers  of  the  visceral  pleura.  Blebs  represent  the  coalescence  of  air  from  small  ruptures  of  terminal  alveoli  that  have  dissected  through  the  interstitium  to  form  a  small  subpleural  collection.  Such  lesions  may  present  symptomatically  with  a  spontaneous  pneumothorax.  A  nontraumatic  or  iatrogenic  pneumothorax  in  patients  without  clinically  apparent  lung  disease  is  termed  a  “primary  spontaneous  pneumothorax”  (PSP).  Although  carrying  no  diagnosis  of  underlying  lung  disease,  most  patients  with  PSP  are  found  to  have  multiple  subpleural  blebs  at  the  time  of  surgery  and  smoking  has  been  observed  to  significantly  increase  the  risk  of  its  development.1,2  Pathologically,  bleb  formation  occurs  secondary  to  mechanical  stress  from  increased  intrathoracic  pressure  in  the  lung  tissue  that  is  predisposed  to  deformation  by  weakness  of  the  connective  tissue.  The  lesions  that  result  in  spontaneous  pneumothorax  are  located  predominantly  in  the  apex  of  the  upper  lobe  or  the  apex  of  the  superior  segment,  where  there  is  increased  mechanical  stress.3  Surgical  therapy  thus  is  oriented  to  the  apex  of  the  lung.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/20
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1170412650
ER  -