Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

In patients presenting with severe dyspnea, several diagnostic challenges arise in distinguishingthe diagnosis of pneumothorax versus several other pulmonary etiologies like bullous lung disease,pneumonia, interstitial lung disease, and acute respiratory distress syndrome. Distinguishingbetween large pulmonary bullae and pneumothorax is of the utmost importance, as the acutemanagement is very different. While multiple imaging modalities are available, plain radiographsmay 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 largepulmonary bleb mimics the lung point and therefore inaccurately suggests pneumothorax. [West JEmerg Med. 2015;16(3):447–449.]