Can severe pulmonary bullae cause pleural effusion?

Generally, severe pulmonary bullae alone do not directly cause pleural effusion. However, when a bulla ruptures and leads to complications, pleural effusion may develop. The detailed analysis is as follows:

Pulmonary bullae are cystic cavities formed by the rupture and fusion of alveolar walls in localized lung tissue. Simple pulmonary bullae primarily affect lung function, manifesting as chest tightness and shortness of breath. The cavities contain gas and do not directly leak fluid to form pleural effusion. Patients with this condition can reduce the risk of disease progression by avoiding strenuous exercise and properly managing underlying lung diseases.

If a severe pulmonary bulla ruptures, it may cause pneumothorax. The resulting pneumothorax can compress lung tissue, leading to local lung injury, or be complicated by pulmonary infection or hemorrhage. These conditions can stimulate the pleura to produce exudative fluid, thereby causing pleural effusion. In such cases, patients may experience worsening chest pain and increased difficulty breathing, requiring prompt medical attention.

Patients with pulmonary bullae should quit smoking, avoid exposure to irritants such as dust and smoke, and take preventive measures against pulmonary infections. They should also avoid actions that may increase intrapulmonary pressure—such as severe coughing or lifting heavy objects—and undergo regular pulmonary imaging follow-ups to monitor changes in the bullae.