1
|
Garge S, Mahalik S, Jain P. Bilateral congenital lobar emphysema: a rare entity and a therapeutic challenge. ANNALS OF PEDIATRIC SURGERY 2022. [DOI: 10.1186/s43159-022-00224-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
Bilateral congenital lobar emphysema is an extremely rare condition, and detailed workup of these patients is very important. Operative intervention is usually based on radiological, biochemical, and clinical details. Bronchoscopy gives an added advantage in cases with diagnostic dilemmas and makes the treatment more evidence based. We here present three cases and review the literature for this rare entity.
Material and methods
We retrospectively collected data about all the cases of bilateral CLE operated by the authors at various centres over the period of 3 years from January 2016 to December 2018.
Results
We managed three cases of bilateral CLE, and all three had unique details based on which treatment was planned. We operated three cases of this very rare entity and compared our findings with 23 cases from the literature reviewed.
Conclusion
We propose that bronchoscopy should be an essential component in the management of all cases of CLE. It helps in defining pathology, the severity of the disease, and the decision on which side to be operated first and avoids unnecessary simultaneous lobectomies. We recommend case selection on basis of radiological, biochemical, clinical, and bronchoscopy criteria. Based on this, an approach of sequential lobectomies is less risky and should be advocated in most of the patients.
Collapse
|
2
|
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]
|
3
|
Zinaye A, Zeray A. Bilateral congenital lobar overinflation (CLO) – a rare presentation of an uncommon condition. Radiol Case Rep 2022; 17:3481-3484. [PMID: 35912289 PMCID: PMC9334927 DOI: 10.1016/j.radcr.2022.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/02/2022] [Accepted: 07/05/2022] [Indexed: 10/25/2022] Open
|
4
|
Gan F, Xia L, Yang Y, Pu Q, Liu L. Fatal congenital lobar emphysema in a puerpera: a case report and literature review. BMC Pulm Med 2021; 21:421. [PMID: 34930207 PMCID: PMC8686282 DOI: 10.1186/s12890-021-01787-x] [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] [Received: 05/17/2021] [Accepted: 12/10/2021] [Indexed: 02/08/2023] Open
Abstract
Background Congenital lobal emphysema (CLE) is a developmental lung abnormality usually diagnosed in the neonatal period and is rarely observed in adults. Adults with CLE are usually asymptomatic and only a small fraction may present with coughing, recurrent pneumonia and respiratory distress. In imaging studies, the most frequently affected lobe of CLE is the left upper lobe, followed by the right middle lobe. However, multilobar involvement with severe mediastinal shift is extremely rare. Case presentation We report a case of fatal CLE in a 28-year-old puerpera with postpartum respiratory failure. Chest computed tomography (CT) revealed emphysema of the right upper, middle and lower lobes resulting in adjacent atelectasis. Hyperinflation of the right upper lobe crossed the midline, leading to a deviation of the mediastinal structure to the left hemithorax and severe compression of the left lung. Conclusions Early and timely diagnosis of CLE with routine follow-up is necessary for patients. CLE, especially with multilobar involvement or mediastinal shift, could be life-threatening and should be promptly and aggressively treated to prevent severe complications.
Collapse
Affiliation(s)
- Fanyi Gan
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China.,Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, 610041, China
| | - Liang Xia
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China.,Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, 610041, China
| | - Yushang Yang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Qiang Pu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Lunxu Liu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. .,Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, 610041, China.
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Bhende VV, Sharma TS, Majmudar HP, Pathan SR, Chitaliya A, Kumar A, Trivedi BY. A Novel Approach to Facilitate an Ideal Surgical Correction of Congenital Lobar Emphysema by Using Neonatal Ultrathin Bronchoscopy-Guided Endo-Bronchial Block. Cureus 2021; 13:e17901. [PMID: 34660097 PMCID: PMC8509106 DOI: 10.7759/cureus.17901] [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] [Accepted: 09/12/2021] [Indexed: 11/28/2022] Open
Abstract
This is a case report of a child who had acyanotic congenital heart disease - ventricular septal defect (VSD) and a patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension. The child underwent open-heart surgery - VSD closure with PDA ligation - and six months later was re-admitted for congenital lobar emphysema of the right middle lobe. He underwent successful right middle lobectomy of the lung six months after cardiac surgery under a one-lung ventilation technique in which application of fiber-optic bronchoscope made the surgery safer and more suitable.
Collapse
Affiliation(s)
- Vishal V Bhende
- Pediatric Cardiac Surgery, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Anand, IND
| | - Tanishq S Sharma
- Pediatric Cardiac Surgery, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Anand, IND
| | - Hardil P Majmudar
- Pediatrics, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Anand, IND
| | - Sohilkhan R Pathan
- Clinical Research, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Anand, IND
| | - Amit Chitaliya
- Pediatric and Neonatal, Care Institute of Medical Sciences (CIMS) Hospital, Ahmedabad, IND
| | - Amit Kumar
- Pediatric Cardiology, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Anand, IND
| | - Bhadra Y Trivedi
- Pediatric Cardiology, Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Anand, IND
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Abstract
Congenital lobar emphysema is a rare disease, which is characterized by pulmoner hyperinflation. Depending on the degree of bronchial obstruction, the clinical presentation may be variable. We report a rare case with congenital lobar emphysema in a 38-days-old male infant who presented with severe respiratory distress and hypertension. Air trapping in the left upper lung and significant mediastinal shift to the right were observed on the chest x-ray. Emphysematous changes were detected on the thorax computed tomography and considered as congenital lobar emphysema. The upper left lobectomy was successfully performed by pediatric surgeons. On postoperative follow up, no sign of respiratory distress occurred and the patient was normotensive. In this report, a case with congenital lobar emphysema, which is a rare cause of respiratory distress and hypertension is discussed.
Collapse
Affiliation(s)
- Tuğçe Tural-Kara
- Department of Pediatric Infectious Diseases, Ankara University Medical School, Ankara, Turkey. E-mail.
| | | | | | | |
Collapse
|
10
|
An Unusual Presentation of Congenital Lobar Emphysema. Case Rep Pulmonol 2017; 2017:6719617. [PMID: 28523200 PMCID: PMC5421086 DOI: 10.1155/2017/6719617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 03/30/2017] [Indexed: 02/05/2023] Open
Abstract
Congenital lobar emphysema is an uncommon bronchopulmonary malformation characterized by lobar overinflation and accompanying alveolar septum damage that leads to compression atelectasis of the lung parenchyma and displacement of mediastinal structures, with the resultant ventilation-perfusion mismatch. We present a case of a 33-year-old lady with progressive exertional dyspnea. Chest radiograph findings lead to the suspicion of congenital lobar emphysema, which was then confirmed by a computed tomography (CT) scan. This condition is most commonly identified in newborns, with very few cases being reported in adults. Lobectomy remains the treatment of choice and in general has good outcome.
Collapse
|
11
|
Left Upper Lobectomy for Congenital Lobar Emphysema in a Low Weight Infant. Case Rep Surg 2016; 2016:4182741. [PMID: 27597924 PMCID: PMC5002461 DOI: 10.1155/2016/4182741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 06/26/2016] [Accepted: 07/21/2016] [Indexed: 11/22/2022] Open
Abstract
Congenital lobar emphysema (CLE) is a rare lung congenital malformation. Differential diagnosis of the disease remains challenging in an infant with acute respiratory distress. We report a case of a 3-week-old female infant with a weight of 2.1 kg who presented respiratory distress related to CLE. Left upper lobectomy was performed and she had an uneventful recovery.
Collapse
|
12
|
Santra A, Dutta P, Manjhi R, Pothal S. Congenital lobar emphysema presenting at late childhood: A rare case report. Lung India 2014; 31:302-4. [PMID: 25125828 PMCID: PMC4129613 DOI: 10.4103/0970-2113.135792] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Avradip Santra
- Critical Care Unit, Fortis Hospital, Anandapur, Kolkata, India
| | - Pravati Dutta
- Department of Pulmonary Medicine, Veer Surendra Sai Medical College and Hospital, Burla, Odisha, India. E-mail:
| | - Rekha Manjhi
- Department of Pulmonary Medicine, Veer Surendra Sai Medical College and Hospital, Burla, Odisha, India. E-mail:
| | - Sudarsan Pothal
- Department of Pulmonary Medicine, Veer Surendra Sai Medical College and Hospital, Burla, Odisha, India. E-mail:
| |
Collapse
|
13
|
Abdellah O, Mohamed H, Youssef B, Abdelhak B. A case of congenital lobar emphysema in the middle lobe. J Clin Neonatol 2013; 2:135-7. [PMID: 24251258 PMCID: PMC3830149 DOI: 10.4103/2249-4847.120000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Congenital lobar emphysema (CLE) is a rare cause of respiratory distress during the neonate period. It is characterized by overinflation of pulmonary lobe, most commonly the left upper lobe or the right middle lobe. We report a case of a 21-day-old baby with the severe respiratory distress. Diagnosis of CLE was made by computed tomography scan and chest X-ray and confirmed by histopathological studies. We would like to draw attention to this rare condition, and discussing their clinical features and management.
Collapse
Affiliation(s)
- Oulmaati Abdellah
- Neonatal Intensive Care Unit, Mother Child Hospital, University Hospital Hassan II, Fez 30000, Morocco
| | | | | | | |
Collapse
|