An unusual bulla in azygoesophageal recess in a patient with secondary spontaneous pneumothorax.

We report a case of secondary spontaneous pneumothorax in which the causative bulla was successfully managed by thoracoscopic surgery. A 64-year-old male was admitted presenting with a right pneumothorax. Chest computed tomography revealed a bulla located in the azygoesophageal recess. Thoracoscopic surgery confirmed an unusual bulla extending along the thoracic spine with a fistula at the tip. We describe the intriguing features of this unique bulla and speculate on its aetiology for the first time.