Findings were due to congenital lobar emphysema
involving left upper lobe.
The management of congenital lobar emphysema
has traditionally been surgical but due to advancement in imaging techniques, this lesion is frequently diagnosed in either asymptomatic or mildly symptomatic infants, prompting to adopt more conservative approach to these children.
Other causes of respiratory distress in a neonate (1,4) Diagnosis Diaphragmatic hernia Usually diagnosed prenatally Pulmonary agenesis / hypoplasia Congenital cystic adenomatoid malformation (CCAM) / sequestrated segment Congenital lobar emphysema
Cardiac failure / left to right shunt / Delayed diagnosis congenital heart disease Persistent foetal circulation / patent ductus arteriosus (PDA) Pulmonary oedema
Congenital lobar emphysema
usually presents at birth (33%) or within the first month of life (50%) with moderate respiratory distress.
The histopathological parameters chosen for the diagnosis of congenital lobar emphysema
were found to be very useful, adjunct to the routine description.
3 Surgical removal of the symptomatic cyst is the rule; however, observation is being carried out by pulmonologists in asymptomatic individuals or those with mild symptoms in Congenital Lobar Emphysema
on the premise that spontaneous resolution has been documented.
CONCLUSION: We conclude that the successful outcome of a patient with congenital lobar emphysema
depends upon the thorough understanding of pathophysiology of one lung ventilation, methods of lung isolation, maintaining perioperative hemodynamic stability and good postoperative ventilation with adequate postoperative analgesia.
The differential diagnosis includes pleuropulmonary blastoma (PPB), pulmonary sequestration, congenital lobar emphysema
, diaphragmatic hernia, bronchogenic cyst and cystic bronchiectasis.