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Onufry Torbus, Józef Dzielicki, Magdalena Jachimowicz, Anna Pikiewicz-Koch, Maria Mielczarek, Marcin Pięta, Jan Głowacki
CaseRepClinPractRev 2002; 3(4):260-263
Background: The authors present the case of a neonate with congenital lobar emphysema treated with an atypical method.
Case report: Progressive respiratory disturbances requiring resuscitation were present since the first moments of the patient’s life. Chest X-ray revealed an excessively bright image of the right lung with mediastinal structures displaced to the left and signs of compression atelectasis of the other lung. After one week mechanical ventilation, improvement of respiratory function allowing spontaneous breathing was obtained. Bronchoscopy performed in the second week of life revealed a fissure-like stenosis of the middle lobe bronchus, due mainly to edema and folded mucosa. According to the scheduled treatment, after aspiration of bronchial secretion, the bronchial
lumen was obstructed using a rubber stopper. The condition of the infant after the procedure was good. Regression of emphysematous changes was observed during 2.5-year follow-up. The last control chest X-ray revealed
normal ventilation of both lungs.
Conclusion: Surgical treatment of congenital emphysema is not obligatory. Conservative, bronchoscopic management is a safe and effective method of treatment in congenital lobar emphysema.