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Congenital Diaphragmatic Hernia, Pulmonary Adenomatoid Malformation, Sequestration, and Lobar Emphysema in Pediatric Emergency Care. Pediatr Emerg Care 2022; 38:e1692-e1695. [PMID: 36413428 DOI: 10.1097/pec.0000000000002883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Sawant V, Prabhudesai S, Sawant B, Das S. One-Stage Bilateral Lobectomy in an Infant with Bilateral Congenital Lobar Emphysema. J Indian Assoc Pediatr Surg 2021; 26:348-350. [PMID: 34728925 PMCID: PMC8515528 DOI: 10.4103/jiaps.jiaps_168_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/06/2020] [Accepted: 08/15/2020] [Indexed: 11/14/2022] Open
Abstract
We report a 4-month-old baby presenting with bilateral congenital lobar emphysema. A two-staged bilateral lobectomy was planned, but bilateral lobectomy had to be performed as a single-staged procedure. Data are scarce on the appropriate approach to children with bilateral involvement. Both single-staged and two-staged procedures have shown variable success.
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Affiliation(s)
- Vishal Sawant
- Department of Pediatric Surgery, Healthway Hospital, Kadamba Plateau, Old Goa, Goa
| | - Sumant Prabhudesai
- Pediatric Intensive care Unit, Healthway Hospital, Kadamba Plateau, Old Goa, Goa
| | - Bharati Sawant
- Department of Anesthesia, Healthway Hospital, Kadamba Plateau, Old Goa, Goa
| | - Sujoy Das
- Department of Pediatric Surgery, Healthway Hopsital, Kadamba Plateau, Old Goa, Goa and Aster Hospital, Margao, Goa, India, Goa
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Warwick H, Guillem J, Batchelor D, Schwarz T, Liuti T, Griffin S, Keenihan E, Theron ML, Specchi S, Lacava G, Mortier J. Imaging findings in 14 dogs and 3 cats with lobar emphysema. J Vet Intern Med 2021; 35:1935-1942. [PMID: 34145623 PMCID: PMC8295672 DOI: 10.1111/jvim.16183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 05/05/2021] [Accepted: 05/17/2021] [Indexed: 11/26/2022] Open
Abstract
Background Lobar emphysema in dogs and cats is caused by bronchial collapse during expiration and subsequent air trapping. Congenital causes such as bronchial cartilage defects or acquired causes such as compressive neoplastic lesions have been reported. Morbidity results from hyperinflation of the affected lung lobe and compression of adjacent thoracic structures. Objective To describe patient characteristics and imaging findings in dogs and cats with lobar emphysema. Animals Fourteen dogs and 3 cats with lobar emphysema diagnosed by imaging findings were retrospectively identified from veterinary referral hospital populations over a 10‐year period. Methods Cases that included thoracic radiography, thoracic computed tomography (CT), or both were included. All images were reviewed by a European College of Veterinary Diagnostic Imaging diplomate. Relevant case information included signalment, clinical findings, treatment, and histopathology where available. Results Ten of 17 (59%) patients were presented for evaluation of dyspnea and 6 (35%) for coughing. Eleven (65%) patients were <3 years of age. The right middle lung lobe was affected in 12 cases (71%) and multiple lobes were affected in 7 cases (41%). Congenital lobar emphysema was suspected in 14 cases (82%). Conclusion and Clinical Importance Lung lobe hyperinflation, atelectasis of nonaffected lung lobes, mediastinal shift, and thoracic wall and diaphragmatic wall deformation were common findings. Lobar or multilobar emphysema should be considered in patients with dyspnea or coughing, particularly younger patients. Although radiography is useful, CT provides better detail. In older patients, acquired causes of bronchial compression should be considered.
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Affiliation(s)
| | - James Guillem
- Small Animal Teaching Hospital, University of Liverpool, Neston, UK
| | - Daniel Batchelor
- Small Animal Teaching Hospital, University of Liverpool, Neston, UK
| | - Tobias Schwarz
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Tiziana Liuti
- Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Roslin, UK
| | - Sally Griffin
- Willows Veterinary Centre and Referral Service, Solihull, UK
| | - Erin Keenihan
- Department of Molecular Biomedical Sciences, NC State Veterinary Hospital, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | | | | | | | - Jeremy Mortier
- Small Animal Teaching Hospital, University of Liverpool, Neston, UK
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Lei Q, Zeng W, Ju R. Congenital lobar emphysema in bilateral lung lobes: a case report. Transl Pediatr 2020; 9:266-271. [PMID: 32775245 PMCID: PMC7347767 DOI: 10.21037/tp-19-147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/11/2020] [Indexed: 11/06/2022] Open
Abstract
Congenital lobar emphysema (CLE) is a rare congenital anomaly of lung. It presents different respiratory symptoms due to affected lobar emphysema, compression atelectasis and mediastinal shift. It can affect one or more lobes. There is usually no typical clinical manifestation in clinic. Typical X-ray can help to diagnose. We report a case of neonatal CLE, which first appeared in the right middle lobar. After right middle lobe (RML) lobectomy, respiratory distress appeared again. Emphysema was found again in the left lower lung. The multiple lobes emphysema appear at different times, and this case occurred after lobectomy.
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Affiliation(s)
- Qiaoling Lei
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Wen Zeng
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, Chengdu, China
| | - Rong Ju
- Department of Neonatology, Chengdu Women's and Children's Central Hospital, Chengdu, China
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Abdel-Bary M, Abdel-Naser M, Okasha A, Zaki M, Abdel-Baseer K. Clinical and surgical aspects of congenital lobar over-inflation: a single center retrospective study. J Cardiothorac Surg 2020; 15:102. [PMID: 32429981 PMCID: PMC7236189 DOI: 10.1186/s13019-020-01145-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/04/2020] [Indexed: 12/04/2022] Open
Abstract
Background Congenital lobar overinflation (CLOI) is one of the most important causes of infantile respiratory distress (RD). We aim to evaluate our experience in CLOI management emphasizing on clinical features, diagnostic modalities, surgery and outcomes. Methods This is a retrospective study for all CLOI cases undergoing surgical management at Qena University Hospital. Demographic data, clinical data, radiographic findings, surgery and postoperative follow-up were reviewed. Results A total of 37 neonates and infants with CLOI were presented to our center between January 2015 and January 2019; their mean age was 111.43 ± 65.19 days and 22 were males. All cases presented with RD; and cyanosis in 19 cases. 15 cases presented with recurrent pneumonia and fever. Diminished breath sounds on the affected side and wheezes were the main clinical findings in 30 and 22 cases respectively. On CXR, emphysema was detected in all cases. A confirmatory CT chest was done for all cases. Left upper lobe was affected in 23 cases, right middle lobe in 7 and right upper lobe in 7 cases. Lobectomy was done in thirty-one cases; their mean age at surgery was 147.58 ± 81.49 days and 19 were males. Postoperative complications were noted in 5 cases and postoperative ventilation was required for 2 of them. No morbidity or mortality was reported. The follow-up duration ranged from 3 months to 1 year and all patients were doing well except one case that lost follow up after 3 months. Conclusion CLOI is a rare bronchopulmonary malformation that requires a high index of clinical suspicion, especially in persistent and recurrent infantile RD. CT chest is the most useful diagnostic modality. Early management of CLOI improves outcome and avoid life-threatening complications. Surgical management is the treatment of choice in our center without recorded mortality.
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Affiliation(s)
- Mohamed Abdel-Bary
- Department of Cardiothoracic Surgery, Qena Faculty of Medicine, South Valley University, Safaga Road, Qena, 83523, Egypt.
| | - Mohamed Abdel-Naser
- Department of Anaesthesia and ICU, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed Okasha
- Department of Radiology, Qena Faculty of Medicine, South Valley University, Qena, Egypt
| | - Mohammed Zaki
- Department of Radiology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Khaled Abdel-Baseer
- Department of Pediatrics, Qena Faculty of Medicine, South Valley University, Qena, Egypt
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Kamath A, Punetha P, Doddamane AN, Chalam KS, Hiremath CS. Airway anomalies in cases of anomalous pulmonary venous connection - A single-center experience. Ann Card Anaesth 2020; 23:14-19. [PMID: 31929241 PMCID: PMC7034199 DOI: 10.4103/aca.aca_43_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background: Patients with congenital heart defects may present with concomitant defects involving other organ systems. Roughly 4 percent of this nature are airway anomalies. Presence of anomalous airways summon major challenge before the anesthesiologist, surgeon, and intensivist in the perioperative management of such patients. There is paucity of literature in the study of airway anomalies in the subset of congenital anomalous pulmonary venous connections. We present the analysis of three cases of airway anomalies in patients operated for anomalous venous drainage at our center. We hope to explicate the clinical implications and management of such rare presentations. Methods: The records of all patients who underwent surgical correction for anomalous venous return between January 2016 and January 2018 were reviewed retrospectively. The records were examined for presence of any airway issues, abnormal radiological findings, perioperative intubation or extubation issues and perioperative surgical findings. Results: Amidst the 410 cases operated for congenital heart defects in this period, 92 were operated cases for anomalous pulmonary venous return, of which 3 patients presented with airway issues. One patient had an aberrant right tracheal bronchus with normal carina and bilateral main bronchial stenosis, the second patient had a hypoplastic left lung and the third patient had congenital lobar emphysema of the left lung. Conclusion: Prudent perioperative management necessitates prior evaluation and preemptive planning for airway anomalies in patients with anomalous venous return, since they can belong to the “Malinosculation Syndrome” group, which involves anomalous communication by means of small openings between the different components of lung tissue, namely, the lung parenchyma, tracheobronchial tree, arteries, and veins.
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Affiliation(s)
- Anuradha Kamath
- Department of Anaesthesia, SSSIHMS, Bengaluru, Karnataka, India
| | - Pankaj Punetha
- Department of Anaesthesia, SSSIHMS, Bengaluru, Karnataka, India
| | - Aditya N Doddamane
- Department of Cardiothoracic Surgery, SSSIHMS, Bengaluru, Karnataka, India
| | - Kolli S Chalam
- Department of Anaesthesia, SSSIHMS, Bengaluru, Karnataka, India
| | - C S Hiremath
- Department of Cardiothoracic Surgery, SSSIHMS, Bengaluru, Karnataka, India
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Demir OF, Hangul M, Kose M. Congenital lobar emphysema: diagnosis and treatment options. Int J Chron Obstruct Pulmon Dis 2019; 14:921-928. [PMID: 31118601 PMCID: PMC6507121 DOI: 10.2147/copd.s170581] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/16/2019] [Indexed: 12/19/2022] Open
Abstract
Although congenital lobar emphysema is a rare lung disease, it can cause severe respiratory distress in the newborn. Lobectomy can be difficult because of the hyperinflated lobe and limited space to carry out surgery. During the past two decades, conservative treatment options have increased for patients with mild and moderate disease.
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Affiliation(s)
- Omer Faruk Demir
- Department of Thoracic Surgery, Erciyes University, Kayseri, Turkey
| | - Melih Hangul
- Department of Pediatrics, Division of Pediatric Pulmonology, Erciyes University, Kayseri, Turkey
| | - Mehmet Kose
- Department of Pediatrics, Division of Pediatric Pulmonology, Erciyes University, Kayseri, Turkey
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Saini S, Prakash S, Rajeev M, Girdhar KK. Congenital Lobar Emphysema: Anaesthetic Challenges and Review of Literature. J Clin Diagn Res 2017; 11:UD04-UD06. [PMID: 29207814 DOI: 10.7860/jcdr/2017/26318.10617] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 08/01/2017] [Indexed: 11/24/2022]
Abstract
Congenital Lobar Emphysema (CLE) is a developmental anomaly, characterized by hyperinflation of one or more pulmonary lobes. It presents in infancy with variable degree of respiratory distress due to compression atelectasis. It is most often associated with mediastinal shift with subsequent hypoxia. CLE poses a diagnostic and therapeutic dilemma. We report a case of five-month-old infant of CLE requiring left lobectomy, who was previously being treated for pneumonia which was unresponsive to medical therapy. Anaesthetic challenges experienced during the case and a brief review of literature is presented.
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Affiliation(s)
- Suman Saini
- Associate Professor, Department of Anaesthesia, V.M.M.C and Safdarjung Hospital, New Delhi, India
| | - Smita Prakash
- Professor, Department of Anaesthesia, V.M.M.C and Safdarjung Hospital, New Delhi, India
| | - Meera Rajeev
- Postgraduate, Department of Anaesthesia, V.M.M.C and Safdarjung Hospital, New Delhi, India
| | - K K Girdhar
- Professor and Head, Department of Anaesthesia, V.M.M.C and Safdarjung Hospital, New Delhi, India
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Badiu I, Hiriscau A, Lupan I, Samasca G. Congenital Lobar Emphysema in Infants. MAEDICA 2017; 12:133-135. [PMID: 29090035 PMCID: PMC5649035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Congenital lobar emphysema in infants is a disorder that is detected most often in newborns or young infants. We report here the case of a 4-month-old infant who at two months suddenly presented upper respiratory infections, treated symptomatically, but evolution showed shortness of breath, wheezing, weight deficit. Thoracic ultrasound revealed left upper lobe hyperinflation causing mediastinal displacement to the right, a slightly reduced blood supply at this level, and a lobar emphysema appearance. Bronchoscopy evidenced a thickening in the left bronchial tree, due to left upper lobe emphysema.
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Affiliation(s)
- Ioana Badiu
- Iuliu Hatieganu University of Medicine and Pharmacy, Department of Pediatrics, IIIrd Pediatric Clinic, Cluj-Napoca, Romania
| | - Anca Hiriscau
- Iuliu Hatieganu University of Medicine and Pharmacy, Department of Pediatrics, IIIrd Pediatric Clinic, Cluj-Napoca, Romania
| | - Iulia Lupan
- Babes-Bolyai University, Department of Molecular Biology and Biotechnology, Cluj-Napoca, Romania
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