Source: Annual Congress 2002 - Chest trauma, airways and miscellaneous

Abstract

BACKGROUND:
Congenital lobar emphysema (CLE) is an important cause of respiratory distress in early infancy. Usually a single lobe is affected, bilateral cases being extremely rare.
PATIENT AND METHOD:
A four week old, male infant was referred with increasing respiratory distress. Chest x-ray (CXR), CT scan, ventilation/perfusion scan were consistent with bilateral CLE affecting the left upper lobe(LUL) and right middle lobe (RML). Bronchoscopy revealed bronchomalacia affecting left main and RML bronchi. Barium swallow and echocardiography were normal.
Left upper lobectomy was done through standard left posterolateral thoracotomy. Unfortunately respiratory distress and a supplemental oxygen requirement persisted. CXR confirmed worsening RML emphysema and right middle lobectomy was performed. Postoperatively the respiratory distress resolved and he was discharged in air in 6 days.
DISCUSSION:
Of eight previously reported cases of bilateral CLE, one underwent unilateral lobectomy. Five patients underwent bilateral lobectomies and three of these patients were operated bilaterally in one session. It frequently seems to affect LUL amd RML.
CONCLUSION:
Bilateral CLE is a rare condition and bilateral lobectomies are required in more severe cases. This can be done as one or two staged procedure. The advantage of two-staged procedure is the possibility of avoiding the need for second lobectomy. Detailed workup of these patients is important.

Rating:

Share or cite this content

Citations should be made in the following way:
S. Maiya, D. Maya, D. Parikh, J. Clarke, P. Weller (Birmingham, United Kingdom). Bilateral congenital lobar emphysema: surgical strategy. Eur Respir J 2002; 20: Suppl. 38, 985

Member's Comments

No comment yet.

Related content which might interest you: A novel non-surgical treatment of symptomatic congenital lobar emphysema Source: International Congress 2016 – Airway stenting and ablation Year: 2016 Wait-and-see strategy in a baby with congenital lobar emphysema (CLE) Source: Eur Respir J 2007; 30: Suppl. 51, 401s Year: 2007 Congenital cystic adenomatoid malformation presenting as in-flight systemic air embolisation Source: Eur Respir J 2007; 30: 801-804 Year: 2007 Anterior mediastinal plasty during pneumonectomy as prevention of mediastinal hernia in patients with widespread pulmonary tuberculosis. Source: Virtual Congress 2020 – Thoracic surgery: developments in diagnostics and outcomes Year: 2020 Omentoplasty for managing post-surgery complications of aspergilloma in a case of right pulmonary artery agenesis Source: Annual Congress 2011 - General thoracic surgery II Year: 2011 Congenital lobar overinflation in adults - A case series Source: International Congress 2018 – Management of chronic cough and respiratory muscle dysfunction Year: 2018 Two cases of extralobar pulmonary sequestration: a rare congenital malformation Source: Eur Respir J 2007; 30: Suppl. 51, 171s Year: 2007 Single-stage bilateral VATS lungs resection from the unilateral access in patients with pulmonary tuberculosis Source: International Congress 2019 – Thoracic surgery Year: 2019 Results of surgical treatment of congenital lung malformation in adults: surgical evolution from thoracotomy to video-assisted thoracic surgery Source: Virtual Congress 2020 – Thoracic surgery: developments in diagnostics and outcomes Year: 2020 Congenital lung malformations and their long-term consequences Source: ISSN=1025-448x, ISBN=1-904097-22-7, page=81 Year: 2002 Surgical treatment of congenital cystic adenomatoid malformation in children Source: Eur Respir J 2003; 22: Suppl. 45, 324s Year: 2003 Unilateral diaphragmatic paralysis after a right-sided empyema in a paediatric patient Source: Eur Respir J 2005; 26: Suppl. 49, 623s Year: 2005 Surgical management of pulmonary hydatid cyst with a thoracoscopic approach Source: International Congress 2018 – Pleural effusions, infections and tumours Year: 2018 Antenatal sildenafil-simvastatin combination attenuates pulmonary hypoplasia and hypertension in nitrofen-induced congenital diaphragmatic hernia Source: International Congress 2016 – The nature of pulmonary hypertension Year: 2016 Surgical approach in pulmonary aspergilloma Source: Eur Respir J 2004; 24: Suppl. 48, 628s Year: 2004 Pulmonary vascular development in congenital diaphragmatic hernia Source: Eur Respir Rev, 27 (147) 170104; 10.1183/16000617.0104-2017 Year: 2018 Cystic lesions of the lung in children: classification and controversies Source: ISSN=ISSN 1025-448x, ISBN=ISBN 978-1-904097-51-8, page=1 Year: 2007 Putting her back together again: A case report of simultaneous lobectomy for congenital cystic adenomatoid malformation and repair of pectus excavatum in a 2 year old child Source: Annual Congress 2010 - Congenital lesions and rare pathology Year: 2010 Congenital cystic adenomatoid malformation with coexisting congenital heart disease: a case series Source: Annual Congress 2007 - Paediatric respiratory epidemiology: rare diseases, infectious diseases and asthma Year: 2007 Surgical treatment of pulmonary congenital malformations (PCM) in infancy and childhood Source: Eur Respir J 2006; 28: Suppl. 50, 275s Year: 2006