CT-guided drainage for patient with giant emphysematous bulla who was invalid 40 days after placement of EBV: a case report

Background: Bullectomy is preferred for the treatment of giant emphysematous bulla (GEB). For the surgically unfit candidates, bronchoscopic placement of one-way endobronchial valve (EBV) and intracavitary drainage of bulla have been considered as alternative strategies. Case presentation: In this report, we present a surgery unfit patient with giant emphysematous bulla in the left lower lobe who was not effective 40 days after EBV placement. As the patient was reluctant to EBV placement again, CT-guided bulla drainage was performed together with bronchial occlusion by bronchoscopy and instilling of autologous blood into the bulla. The patient had immediate and sustained symptomatic relief with significant improvement in lung function. Conclusion: CT-guided bulla drainage is a simple, minimally invasive treatment method for inoperable GEB patients.