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Lung Bleb
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Lung Bleb

I've been told that my 10 year old son possibly has a lung bleb.  This was found through an xray on his 10 yr check up after he told his doctor he sometimes has trouble breathing.  After seeing a pulmonary doctor they prescribed him prevacid and told me to come back in a month and if he's still having problems then they'll do a catscan.  My question is, should I have them do a catscan regardless?  What will the catscan tell me? If this is a "BLEB" should I be concerned with the fact that he is extremely active in sports particularly baseball and hockey?  If this is a BLEB is there a way to get rid of it?  
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Blebs are small collections of air on the pleural surface of the lung that are associated with an increased risk of pneumothorax, which is leakage of air out of the lung into the pleural space.  This is not to say that someone with one or a small number of blebs will inevitably, at some time, have a pneumothorax or that physical activity should be limited to any degree, for fear of a pneumothorax.  Cysts or bullae are also "collections of air", but located within the substance of the lung.  Unless large, they are harmless.  Nor is a single bleb, or even several blebs, an indicator of serious lung disease.

That your son "sometimes has trouble breathing" is, in all probability, unrelated to the bleb and, in a 10 year old, would much more likely to be caused by exercise induced asthma (EIA).  He should have pulmonary function tests (PFTs) before and after inhaling a bronchodilator and an exercise test for EIA.  A methacholine challenge might also be performed to confirm the diagnosis of asthma.  Only then, should consideration be given to doing a CT scan of his lungs.  Do not be overly concerned, should your son prove to have asthma.  It is a very treatable disease and definitely not a reason to limit his activity in sports.

Blebs can be surgically removed and/or the lungs can be affixed to the chest wall but such procedures should only be performed after more than one sizable pneumothorax.

The Prevacid® (lansoprazole) was probably prescribed based on the suspicion of gastroesophageal reflux disease (GERD), commonly called acid reflux, which can precipitate asthma.  You should confirm this with his pulmonary doctor and consider discussing the above information with him/her, as well.

Good luck.
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