Recurrent pneumothorax associated with a pulmonary emphysematous bulla in a dog: surgical correction and proposed pathogenesis.

A three year old dog was affected with recurrent dyspnea for two months, due to a recurrent pneumothorax. This followed an episode of mild blunt trauma to the thorax and transient strangulation. Conservative therapy of aspiration of air by repeated thoracentesis gave only temporary relief. Thoracic radiographs indicated the presence of a bulla in the right middle lung lobe. An exploratory thoracotomy confirmed the diagnosis, and a lobectomy was successfully performed. The pathogenesis of acquired pulmonary bullae is postulated. Reasons for the predisposition of the right middle lung lobe are outlined. These are related to the anatomy of the right middle bronchus, and include its position between the right pulmonary artery and vein, its oval shape, and the absence of cartilagenous support at its origin.