Spontaneous Pneumothorax Due to Ruptured Bulla of the Azygos Lobe.

Azygos lobe is an uncommon anatomic variant that is widely recognized, but rarely associated with pneumothorax. We present a successful surgical management of a spontaneous pneumothorax resulting from rupture of a bulla in an incidentally discovered azygos lobe. The patient is a 73-year-old man who presented with the first-time occurrence of a spontaneous right pneumothorax. The patient did not tolerate nonoperative management and underwent a right thoracotomy with bullae resection in the azygos and right lower lobes for definitive management. Our treatment highlights several considerations during operative management of azygos lobe pathology.