Unrecognized hyperlucent lesion on lateral film of chest X-R
Published in the Annals of Cardiac Anaesthesia, the authors present a case of a 68-year-old male patient who reported with the history of angina on routine activities NYHA-II for the last 2 years. After investigations, he was found to have coronary artery disease and was posted for off-pump coronary artery bypass (CABG).

After median sternotomy when pleura was opened for harvesting right internal mammary artery, a large bulla was found in the right upper lobe of the lung although the preoperative pulmonary function tests of the patient were normal. After completing the anastomosis of off-pump CABG, bullectomy was done.

When the chest X-ray (CXR) of the patient was looked up, CXR posteroanterior (PA) view did not reveal any findings of bulla, while CXR lateral view had a large hyperlucent region behind the sternum. Earlier, the clinicans could not make out the etiology of hyperlucent lesion in CXR lateral view; however, after opening of pleura, they realized that it corresponded to the large bulla of right upper lobe of the lung.

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