Acute Worsening of Congenital Lobar Emphysema with Subsequent Spontaneous Improvement

The degree of respiratory dysfunction and subsequent morbidity of patients with congenital lobar emphysema (CLE) are related to the degree of hyperinflation of the involved lobe.1 Whereas neonates with severe CLE may have marked respiratory distress requiring surgical resection of the hyperinflated lobe, children with mild forms of CLE seldom have a sudden increase in size of the involved lobe leading to respiratory failure.2,3 We report two infants with mild CLE who were clinically stable and developed respiratory distress with increased hyperinflation of the involved lobe associated with an acute respiratory tract infection. Both infants returned to their base line clinical status with conservative therapy alone following resolution of their respiratory illness.

Download Full-text

Congenital lobar emphysema: a rare cause of respiratory distress in a neonate

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20185214 ◽

2018 ◽

Vol 6 (1) ◽

pp. 218

Author(s):

Nishant Mittal ◽

Ankit Parakh ◽

Prashant Jain ◽

N. K. Mittal

Keyword(s):

Early Intervention ◽

Respiratory Distress ◽

Treatment Options ◽

Term Outcome ◽

Long Term Outcome ◽

Congenital Lobar Emphysema ◽

Congenital Condition ◽

Lobar Emphysema ◽

Intervention Message ◽

The Right

Congenital lobar emphysema (CLE) is a congenital condition characterized by distension and air trapping of the affected lobe of the lung. It is one of the causes of infantile respiratory distress, which may require surgical resection of affected lobe. Case characteristics: 3-day-old neonate with ventilation refractory respiratory distress. Imaging was suggestive of decreased lung tissue on the right side with ipsilateral mediastinal shift. Intervention/ outcome: Early surgical lobectomy was done to improve lung functions and the child improved dur to early intervention. Message: An early diagnosis with high index of suspicion helps patients with this rare congenital anomaly. Early intervention is the key to good long-term outcome. More awareness about the entity and treatment options available would greatly help improving the outcome and disease burden.

Download Full-text

Not all infantile respiratory distress in winter is bronchiolitis: congenital lobar emphysema

BMJ Case Reports ◽

10.1136/bcr.08.2011.4618 ◽

2011 ◽

Vol 2011 (oct20 1) ◽

pp. bcr0820114618-bcr0820114618 ◽

Cited By ~ 2

Author(s):

L. Taqvi ◽

M. Griksaitis ◽

K. Eastham

Keyword(s):

Respiratory Distress ◽

Congenital Lobar Emphysema ◽

Lobar Emphysema

Download Full-text

Congenital lobar emphysema: a rare cause for respiratory distress in newborns and

Sri Lanka Journal of Surgery ◽

10.4038/sljs.v36i3.8525 ◽

2018 ◽

Vol 36 (3) ◽

pp. 3

Author(s):

I. H. D. S Pradeep ◽

Dhammika Rasnayaka ◽

Ridma Jayarathna

Keyword(s):

Respiratory Distress ◽

Congenital Lobar Emphysema ◽

Lobar Emphysema

Download Full-text

Congenital Lobar Emphysema: Perioperative Evaluation and Management

The Heart Surgery Forum ◽

10.1532/hsf.3823 ◽

2021 ◽

Vol 24 (3) ◽

pp. E517-E521

Author(s):

Montaser Elsawy Abd Elaziz ◽

Mohamed Gaber Elsayed ◽

Mohamed Ahmed El-hag Aly

Keyword(s):

Respiratory Distress ◽

Surgical Management ◽

University Hospital ◽

Recurrent Pneumonia ◽

Diagnostic Modality ◽

Early Management ◽

Congenital Lobar Emphysema ◽

The Mean ◽

Lobar Emphysema

Background: Congenital lobar emphysema (CLE) is a lung malformation characterized by overdistension and air trapping in the affected lobe. It is one of the causes of neonatal and infantile respiratory distress. This study aimed to evaluate our experience regarding perioperative and surgical management in children with CLE. Methods: A retrospective observational study was done for all CLE patients who underwent surgery at Menoufia University Hospital. Perioperative data collected included demographic, clinical, and radiological findings, as well as operative and postoperative data. Results: We included 30 neonates and infants who suffered from CLE between January 2013 and December 2020; the mean age was 111.43 ± 65.19 days, and 21 were males. All cases presented with respiratory distress; 19 had cyanosis, and 15 had recurrent pneumonia and fever. Plain chest x-ray and computed tomography (CT) revealed emphysema in all cases. Lobectomy was done in all cases; the mean age at surgery was 147.58 ± 81.49 days. Postoperative complications occurred in 5 patients, and 2 of them needed mechanical ventilation. The follow-up duration ranged from 3 months to 1 year (except 1 case lost to follow-up after 3 months), and all patients were doing well. Conclusion: CLE is a rare bronchopulmonary malformation that requires a high index of clinical suspicion, especially in persistent and recurrent infantile respiratory distress. Chest CT is the most useful diagnostic modality. Early management of CLE improves outcome and prevents life-threatening complications. Surgical management is the treatment of choice in our center, without recorded mortality.

Download Full-text

Congenital lobar emphysema: 30-year case series in two university hospitals

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132013000400004 ◽

2013 ◽

Vol 39 (4) ◽

pp. 418-426 ◽

Cited By ~ 16

Author(s):

Daniele Cristina Cataneo ◽

Olavo Ribeiro Rodrigues ◽

Erica Nishida Hasimoto ◽

Aurelino Fernandes Schmidt Jr ◽

Antonio Jose Maria Cataneo

Keyword(s):

Surgical Treatment ◽

Respiratory Distress ◽

Case Series ◽

X Rays ◽

University Hospitals ◽

Radiographic Findings ◽

Congenital Lobar Emphysema ◽

Lateral Muscle ◽

Lobar Emphysema

OBJECTIVE: To review the cases of patients with congenital lobar emphysema (CLE) submitted to surgical treatment at two university hospitals over a 30-year period. METHODS: We reviewed the medical records of children with CLE undergoing surgical treatment between 1979 and 2009 at the Botucatu School of Medicine Hospital das Clínicas or the Mogi das Cruzes University Hospital. We analyzed data regarding symptoms, physical examination, radiographic findings, diagnosis, surgical treatment, and postoperative follow-up. RESULTS: During the period studied, 20 children with CLE underwent surgery. The mean age at the time of surgery was 6.9 months (range, 9 days to 4 years). All of the cases presented with symptoms at birth or during the first months of life. In all cases, chest X-rays were useful in defining the diagnosis. In cases of moderate respiratory distress, chest CT facilitated the diagnosis. One patient with severe respiratory distress was misdiagnosed with hypertensive pneumothorax and underwent chest tube drainage. Only patients with moderate respiratory distress were submitted to bronchoscopy, which revealed no tracheobronchial abnormalities. The surgical approach was lateral muscle-sparing thoracotomy. The left upper and middle lobes were the most often affected, followed by the right upper lobe. Lobectomy was performed in 18 cases, whereas bilobectomy was performed in 2 (together with bronchogenic cyst resection in 1 of those). No postoperative complications were observed. Postoperative follow-up time was at least 24 months (mean, 60 months), and no late complications were observed. CONCLUSIONS: Although CLE is an uncommon, still neglected disease of uncertain etiology, the radiological diagnosis is easily made and surgical treatment is effective.

Download Full-text

Evaluation of Clinical Outcomes in Neonates Undergoing Lung Resection for Congenital Lesions

Journal of Child Science ◽

10.1055/s-0037-1603772 ◽

2017 ◽

Vol 07 (01) ◽

pp. e4-e9

Author(s):

Hemonta Dutta ◽

Madhuchanda Bora ◽

Diganta Saikia

Keyword(s):

Postoperative Complications ◽

Respiratory Distress ◽

Epidural Anesthesia ◽

Lung Resection ◽

Lung Lesions ◽

Congenital Lobar Emphysema ◽

Presenting Symptoms ◽

Lobar Emphysema ◽

Neonates And Infants

Objective The purpose of this study is to review our experience with neonates and infants with congenital lung lesions emphasizing natural history, management, and outcomes. Methods A total of 29 neonates and infants presented with congenital lung lesions between 2000 and 2015. Two patients died before surgery due to complications, and one patient refused surgery. Overall, 26 of them were subjected to surgical treatment and were included in the study. Demographic data, indications for surgery, operative procedure, complications, hospital stay, and follow-up were assessed. Results A total of 26 children aged 5 to 122 days (mean: 35.5 days, 14 males) presented with various congenital lung malformations: congenital lobar emphysema in 10, congenital cystic adenomatous malformation in 8, bronchogenic cyst in 5, and pulmonary sequestration in 3 patients. Respiratory distress and respiratory tract infection were the most common presenting symptoms noted in 22 patients. In three patients the lesion was detected incidentally on chest X-ray. Lobectomy was the most common operation (19/26). Postoperative complications were noted in 12 patients. One patient died due to postoperative sepsis. Postoperative ventilation was required in 24 patients. Patients in the asymptomatic group recovered without any complications. The follow-up period ranged from 3 months to 15 years (median: 76.3 months). Only 12 patients received epidural anesthesia and had a better recovery than the other patients. Conclusion Congenital lobar emphysema was the most common congenital lung lesion in our series. Respiratory distress and respiratory infection were the most common symptoms. Neonates and infants tolerated lung resection well. Use of epidural anesthesia led to less postoperative complications.

Download Full-text