P0391 / #814: CONGENITAL LOBAR EMPHYSEMA IN A LACTENT DISCOVERY DUE AN SECONDARY BRONCHIOLITIS- CASE REPORT

Abstract

Aims & Objectives: Congenital lobar emphysema (CLE) is a rare developmental lung malformation. Its incidence is 1/20,000–30,000 live births;This report tend to show one CLE discover secondary to an bronchiolitis case that lead the patient to emergency department and secondary to pediatric intensive care unit Methods: Case report of congenital lobar emphysema in a lactent discovery due secondary bronchiolitis Results: ICS, male, 3 months of age, was admitted to Hospital Alvorada de Moema - São Paulo, with acute respiratory failure. Infant with a history of cough and nasal obstruction for 8 days, developing with dyspnea 02 days after admission. On physical examination, he was tachydispneic with mild stridor. Chest X-ray revealed hypertransparency on the left, with deviation of the mediastinum to the right (figure 1). Chest tomography demonstrated hyperinflation of the upper lobe of the left lung(figure 2) and the diagnostic hypothesis of congenital lobar emphysema was considered. Echocardiography within the normal range. For the flu symptoms present, prompted Viral Panel with positive Rhinovirus. Remained under observation in the pediatric ICU, without the need for invasive ventilatory support, until bronchiolitis was resolved for surgical programming. Undergoing left upper lobectomy surgery, remaining in the ICU for 23 days. During hospitalization, he was also submitted to bilateral umbilical and inguinal herniorrhaphy. He was discharged with outpatient follow-up guidanceConclusions: Nearly half of patients are symptomatic at birth, while the other half mostly develop symptoms in the first 6 months of life;The treatment choice for patients with CLE depends on clinical severity like it was in the case report