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West J Emerg Med. 2015 May;16(3):447-9. doi: 10.5811/westjem.2015.3.24809. Epub 2015 Apr 9.

Bleb point: mimicker of pneumothorax in bullous lung disease.

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North Shore University Hospital, Department of Emergency Medicine, Division of Emergency Ultrasound, Manhasset, New York.


In patients presenting with severe dyspnea, several diagnostic challenges arise in distinguishing the diagnosis of pneumothorax versus several other pulmonary etiologies like bullous lung disease, pneumonia, interstitial lung disease, and acute respiratory distress syndrome. Distinguishing between large pulmonary bullae and pneumothorax is of the utmost importance, as the acute management is very different. While multiple imaging modalities are available, plain radiographs may be inadequate to make the diagnosis and other advanced imaging may be difficult to obtain. Ultrasound has a very high specificity for pneumothorax. We present a case where a large pulmonary bleb mimics the lung point and therefore inaccurately suggests pneumothorax.

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