Abstract
Congenital lobar emphysema (CLE) is an uncommon congenital malformation of the lung that can present with respiratory distress in early life. We report a full term female baby who presented with intermittent bluish discoloration of the lips and extremities during crying since birth. An initial diagnosis of left sided collapse-consolidation with right-sided compensatory emphysema was made from chest x-ray. When no improvement was noted after intravenous antibiotic therapy for 7 days, computerized tomographic scan of thorax was done which showed emphysema of the right middle lobe with transherniation and mediastinal shift to the left. Right middle lobectomy was done and postoperative period was uneventful. Histopathological examination of the specimen confirmed the diagnosis of CLE. CLE can mimic more common causes of respiratory distress in neonatal period and needs a high index of suspicion for diagnosis. Early diagnosis and effective surgical treatment is curative.
Highlights
Congenital lobar emphysema (CLE) is a rare congenital malformation of the lung that can cause acute respiratory distress in early life.[1]
We report a full term female baby in whom CLE mimicked as collapse-consolidation of the opposite lung
Right middle lobectomy was curative for the patient
Summary
Congenital lobar emphysema (CLE) is a rare congenital malformation of the lung that can cause acute respiratory distress in early life.[1]. The abnormality is related to intrinsic bronchial narrowing In these cases, weakened or absent bronchial cartilage leads to inspiratory air entry but collapse of the narrow bronchial lumen during expiration resulting in lobar air trapping. Males are more affected than females.[3] Presence of a hyperlucent, hyperexpanded lobe with midline substernal herniation and compression of the remaining lung in computerized tomographic (CT) scan of thorax is usually diagnostic. The condition can mimic more common causes of respiratory distress in neonatal period and needs a high index of suspicion for diagnosis. Clinical awareness of this condition is important for early diagnosis as effective surgical treatment is curative for this condition.
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