Burst or Bluff: A Bulla Masquerading as Tension Pneumothorax in a 2-Year-Old Child

Abstract

This case highlights the diagnostic challenge of differentiating between a pneumothorax and a congenital pulmonary bulla, particularly in a malnourished paediatric patient presenting with chronic respiratory symptoms. Despite initial management with intercostal drainage under the impression of pneumothorax, the absence of lung expansion prompted further imaging, which confirmed congenital bullous disease. Definitive surgical management with an 80 mm linear stapler resection resulted in marked clinical improvement. Early consideration of bullous lung disease in children with atypical or non-resolving pneumothorax is essential to avoid unnecessary interventions and to ensure timely surgical correction for favourable outcomes.