Congenital lobar emphysema: Pitfalls and management

Abstract

Congenital lobar emphysema is a rare entity presenting in the first month of life. It appears with varying degrees of respiratory distress, clinical and radiological evidence of over-aeration of the upper and middle lobes, mediastinal shift and hypoxia. Its early recognition and surgical intervention can be life-saving. Even today, despite advanced diagnostic techniques, pitfalls in diagnosis and management are not uncommon and the condition may be mistaken for pneumothorax or pneumonia. This report elucidates the anesthetic management of three such cases with a review of literature.

Congenital Lobar Emphysema and Intercostal Drainage Tube Insertion: The Common Fate of an Uncommon Disease

“…A series of 3 cases which presented with respiratory distress were mistakenly diagnosed as pneumothorax and an ICD was inserted in all the 3 cases, but later on, all turned out to be CLE [7]. As in our case, the ICD insertion does not help; rather, it may further increase the respiratory distress.…”

Anesthesia in Pediatric Thoracic Surgery

“…Anestezi idamesi sıklıkla inhalasyon anestezikleri ile yapılır. Birçok hasta postoperatif dönemde ekstübe edilir (43).…”

Congenital lobar emphysema of right middle lobe-transition from an opaque lung to hyperlucent lung in a neonate

“…4 Vascular rings that produce compression, bronchial stenosis, bronchial torsion, bronchogenic cysts, polyalveolar lobe and congenital CMV infection have also been reported. [5][6][7][8] CLE is described in twins and occasionally from same family 9 but in 40% of cases, the cause is unknown. The age of onset of symptoms ranges from a few days after birth to 6 months.…”

“…[6] The basic investigation in CLE is the chest radiograph from which a diagnosis can be made often. Other diagnostic modalities used for diagnosis of CLE are CT chest, bronchoscopy, pulmonary angiography and V/Q scintigraphy.…”