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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.
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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.
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Al Jadaan SA, Alaqeel SM, Alsadoun N, Allababidi NH, Alharbi M, Almuzaini AS, Alsuhaibani M, Alsulaiman A. Clinicopathological features of resected pediatric congenital lung and mediastinal lesions: A single institution experience. Saudi Med J 2021; 42:209-212. [PMID: 33563741 PMCID: PMC7989286 DOI: 10.15537/smj.2021.2.25705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 01/14/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives: To evaluate resected congenital lung and mediastinal lesions among children and their characteristics in a single tertiary hospital. Methods: A retrospective chart review analysis of all patients under 14 years of age who underwent congenital lung and mediastinal lesion resection in a single tertiary center from June 1997 to June 2018 was performed. Results: In total, 108 cases of resected lung and mediastinal lesions were performed from June 1997 to June 2018. Congenital lung and mediastinal lesions were found in 52 (48%) cases. Overall, 23 cases were males (44%) and 29 (56%) were females. The most common histopathology was congenital lobar emphysema. Conclusion: This study provides a 21-year review of the clinical and histopathological features of resected congenital lung and mediastinal lesions in a single center. Congenital lung and mediastinal lesions represented 48% of all resected lesions.
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Affiliation(s)
- Saud A. Al Jadaan
- From the Department of Pediatric Surgery, King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Suliaman M. Alaqeel
- From the Department of Pediatric Surgery, King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
- Address correspondence and reprint request to: Dr. Suliaman M. Alaqeel, Department of Pediatric Surgery, King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: https://orcid.org/0000-0003-2778-9710
| | - Nouf Alsadoun
- From the Department of Pediatric Surgery, King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Noor H. Allababidi
- From the Department of Pediatric Surgery, King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Majed Alharbi
- From the Department of Pediatric Surgery, King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Alaa S. Almuzaini
- From the Department of Pediatric Surgery, King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Marya Alsuhaibani
- From the Department of Pediatric Surgery, King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Abdulrahman Alsulaiman
- From the Department of Pediatric Surgery, King Abdullah Specialized Children’s Hospital, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
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Xie J, Wu Y, Wu C. Is thoracoscopy superior to thoracotomy in the treatment of congenital lung malformations? An updated meta-analysis. Ther Adv Respir Dis 2020; 14:1753466620980267. [PMID: 33308023 PMCID: PMC7739138 DOI: 10.1177/1753466620980267] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: A meta-analysis was performed for a comparison of outcomes between video-assisted thoracoscopic surgery (VATS) and thoracotomy for congenital lung malformations (CLM). Methods: Electronic databases, including PubMed, Scopus, Embase, and the Cochrane Library were searched systematically for literature aimed mainly at reporting the therapeutic effects for CLM administrated by VATS and thoracotomy. Results: A total of 40 studies meeting the inclusion criteria were included, involving 2896 subjects. VATS was associated with fewer complications [odds ratio (OR) 0.54; 95% confidence interval (CI), 0.42–0.69], less use of epidural anesthesia (OR, 0.08; 95% CI, 0.03–0.23), shorter length of hospital stay [standard mean difference (SMD) −0.98; 95% CI, −1.4 to −0.55] and chest drainage (SMD, −0.43; 95% CI, −0.7 to −0.17), as compared with thoracotomy. However, thoracotomy showed superiority in reduced operative time (SMD, 0.44; 95% CI, 0.04–0.84). Pearson analysis (Pearson r = 0.85, 95% CI, 0.28 to 0.98, p = 0.01) and linear regression (R square 0.73) confirmed a positive correlation between percentage of symptomatic cases and conversion in patients using VATS. Conclusion: VATS is associated with fewer complications, less use of epidural anesthesia, shorter length of stay and length of chest drainage, but longer operative time, as compared with thoracotomy. Symptomatic patients with CLM using VATS may be prone to conversion to thoracotomy. The reviews of this paper are available via the supplemental material section.
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Goley SM, Sakula-Barry S, Adofo-Ansong N, Isaaya Ntawunga L, Tekyiwa Botchway M, Kelly AH, Wright N. Investigating the use of ultrasonography for the antenatal diagnosis of structural congenital anomalies in low-income and middle-income countries: a systematic review. BMJ Paediatr Open 2020; 4:e000684. [PMID: 32864479 PMCID: PMC7443309 DOI: 10.1136/bmjpo-2020-000684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Congenital anomalies are the fifth leading cause of under-5 mortality globally. The greatest burden is faced by those in low/middle-income countries (LMICs), where over 95% of deaths occur. Many of these deaths may be preventable through antenatal diagnosis and early intervention. This systematic literature review investigates the use of antenatal ultrasound to diagnose congenital anomalies and improve the health outcomes of infants in LMICs. METHODS A systematic literature review was conducted using three search strings: (1) structural congenital anomalies; (2) LMICs; and (3) antenatal diagnosis. The search was conducted on the following databases: Medline, Embase, PubMed and the Cochrane Library. Title, abstract and full-text screening was undertaken in duplicate by two reviewers independently. Consensus among the wider authorship was sought for discrepancies. The primary analysis focused on the availability and effectiveness of antenatal ultrasound for diagnosing structural congenital anomalies. Secondary outcomes included neonatal morbidity and mortality, termination rates, referral rates for further antenatal care and training level of the ultrasonographer. Relevant policy data were sought. RESULTS The search produced 4062 articles; 97 were included in the review. The median percentage of women receiving an antenatal ultrasound examination was 50.0% in African studies and 90.7% in Asian studies (range 6.8%-98.8%). Median detection rates were: 16.7% Africa, 34.3% South America, 34.7% Asia and 47.3% Europe (range 0%-100%). The training level of the ultrasound provider may affect detection rates. Four articles compared morbidity and mortality outcomes, with inconclusive results. Significant variations in termination rates were found (0%-98.3%). No articles addressed referral rates. CONCLUSION Antenatal detection of congenital anomalies remains highly variable across LMICs and is particularly low in sub-Saharan Africa. Further research is required to investigate the role of antenatal diagnosis for improving survival from congenital anomalies in LMICs. PROSPERO REGISTRATION NUMBER CRD42019105620.
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Affiliation(s)
| | | | - Nana Adofo-Ansong
- Department of Paediatrics, Mafikeng Provincial Hospital, Mafikeng, South Africa
| | | | - Maame Tekyiwa Botchway
- Department of Paediatric Surgery, University of the Witwatersrand, Johannesburg-Braamfontein, Gauteng, South Africa
| | - Ann Horton Kelly
- Department of Global Health & Social Medicine, King’s College London, London, UK
| | - Naomi Wright
- King’s Centre for Global Health and Health Partnerships, King’s College London, London, UK
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Kini H, Sreeram S, Shukla S, Rao S, Sahu K, Adiga D, Suresh P. Congenital Pulmonary Airway Malformation - 19-Year Experience from a Tertiary Care Center in India. Fetal Pediatr Pathol 2019; 38:449-459. [PMID: 31084392 DOI: 10.1080/15513815.2019.1613703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: Congenital pulmonary airway malformation (CPAM) is a collection of non-hereditary, developmental anomalies. Our aim was to analyze the histological profiles and prevalence of CPAMs diagnosed in our center. Methods: A retrospective study of all CPAMs diagnosed from January 1999 to May 2018 from a general hospital pathology service was performed. Results: There were 79 cystic lesions encountered in fetuses, neonates, and children, 15 of which were CPAMs {5/2372 (0.21%) autopsies and 10/216026 (0.0046%) surgical resections}. The male:female ratio was 1:1.14. Gestational age of antenatal cases ranged from 22 to 32 weeks, postnatal ages ranged from 7 days to 15 years (mean 2.9 years). The cases were right-sided (8/15;53.3%), left-sided (4/15;26.7%) and bilateral (3/15,20%). Seven (46.7%), 4 (26.7%),3 (20%) and 1 (6.7%) were types 1, 2, 3 and 4, respectively. None of the surgical cases had postoperative mortality or morbidity. Conclusions: Prompt recognition and surgical resectability resulted in normal growth and symptom free survival in our postnatally diagnosed patients. Mortality in antenatally diagnosed fetuses remains high (5/11;45%).
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Affiliation(s)
- Hema Kini
- Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Saraswathy Sreeram
- Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Saumya Shukla
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India, Lucknow, India
| | - Sadashiva Rao
- Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kausalya Sahu
- Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Deepa Adiga
- Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Pooja Suresh
- Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, 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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Affiliation(s)
| | | | - Vanessa Dinoá
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Fernanda Miraldi
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Edson Marchiori
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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King N, Ramesh SS, Essandoh M, Merritt RE. Near Complete Obliteration of the Left Hemithorax by Congenital Lobar Emphysema in an Adult. Ann Thorac Surg 2017; 104:e367-e369. [DOI: 10.1016/j.athoracsur.2017.06.068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 06/15/2017] [Accepted: 06/26/2017] [Indexed: 10/18/2022]
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9
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Choo JY, Hwang J, Lee JH, Lee KY. Bronchopulmonary foregut malformation presenting as extralobar pulmonary sequestration associated with a bronchogenic cyst: an unusual clinical and radiological feature in an adolescent patient. J Thorac Dis 2017; 9:E632-E635. [PMID: 28840031 DOI: 10.21037/jtd.2017.06.101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We present a case of symptomatic complex bronchopulmonary foregut malformation (BPFM), including extralobar pulmonary sequestration and a bronchogenic cyst, in the left anterior mediastinum of a 15-year-old boy. Preoperative computed tomography showed a cystic mass with heterogeneous enhancement of adjacent soft tissue components and pleural effusion. We suggested the infected bronchogenic cyst as the first impression. However, pathological examination after surgical resection revealed extralobar pulmonary sequestration and a bronchogenic cyst with unusual manifestation, which was located in the left upper hemithorax and supplied by the pulmonary artery. In patients presenting with a cystic mass with features of inflammation or infection and collateral vasculature, the possibility of a complex bronchopulmonary foregut malformation should be considered in the differential diagnosis.
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Affiliation(s)
- Ji Yung Choo
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jinwook Hwang
- Department of Thoracic and Cardiovascular Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Joo Han Lee
- Department of Pathology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Ki Yeol Lee
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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Mehta AA, Viswanathan N, Vasudevan AK, Paulose R, Abraham M. Congenital Cystic Adenomatoid Malformation: A Tertiary Care Hospital Experience. J Clin Diagn Res 2016; 10:SC01-SC04. [PMID: 28050458 DOI: 10.7860/jcdr/2016/19205.8775] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 08/24/2016] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Congenital Cystic Adenomatoid Malformation (CCAM) is an uncommon developmental deformity affecting the terminal respiratory structures. It is characterized by broncho pulmonary foregut malformations. The reason behind it is an arrest in lung development between 4th and 7th week of fetal life. AIM The present study was conducted to assess the clinical and radiological profile and also to study the role of surgical intervention in patients with CCAM. MATERIALS AND METHODS All patients with clinical suspicion or provisional diagnosis of CCAM were included in the study. A clinical questionnaire was prepared to collect data. Computed Tomography (CT) chest with High Resolution Computed Tomography (HRCT) was done for all the patients. Patients were assessed by paediatric surgeon and eligible patients were operated. The procedure conducted was usually open thoracotomy under general anaesthesia. The affected lobes were removed and specimens were sent for histopathological analysis. All included patients were followed up prospectively to find out about their current level of health. Via telephonic interview they were asked about their overall growth, quality of life, activity, rate of respiratory infections and requirement of hospital admission. RESULTS Total 15 patients with diagnosis of CCAM were included in the study. Of them, 8 (53.3%) were male. The commonest presentation was cough 13(86%), breathing difficulty 11(73%), fever 9(60%), recurrent pneumonia 4(26%), hypoxia requiring oxygen supplementation 6(40%), others 2(12%). Thirteen patients required surgical intervention and underwent lobectomy. There were 2 cases of type I, one each of type II and III, 3 case of type IV while 5 were intermediate type. There was no procedure related mortality. The median duration of hospital stay and all were successfully discharged with median duration of stay 11±16 days. CONCLUSION The study concludes that if recognized early, surgical removal of affected lung prevents the complications like recurrent pulmonary infections. The surgery is well tolerated without any post-operative mortality or morbidity.
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Affiliation(s)
- Asmita Anilkumar Mehta
- Clinical Professor, Department of Pulmonary Medicine, Amrita Institute of Medical Sciences , Ponekara, Kochi, Kerala, India
| | - Naveen Viswanathan
- Clinical Professor, Department of Paediatric Surgery, Amrita Institute of Medical Sciences , Ponekara, Kochi, Kerala, India
| | - Anil Kumar Vasudevan
- Clinical Professor, Department of Microbiology, Amrita Institute of Medical Sciences , Ponekara, Kochi, Kerala, India
| | - Roopa Paulose
- Associate Professor, Department of Pathology, Amrita Institute of Medical Sciences , Ponekara, Kochi, Kerala, India
| | - Mohan Abraham
- Professor and Head, Department of Paediatric Surgery, Amrita Institute of Medical Sciences , Ponekara, Kochi, Kerala, India
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Prabhu SM, Choudhury SR, Solanki RS, Shetty GS, Agarwala S. Inadvertent chest tube insertion in congenital cystic adenomatoid malformation and congenital lobar emphysema-highlighting an important problem. Indian J Radiol Imaging 2013; 23:8-14. [PMID: 23986612 PMCID: PMC3737621 DOI: 10.4103/0971-3026.113612] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Chest tube insertion in congenital cystic lung lesions is an important problem in children with acute respiratory distress having a cystic lucent lesion on chest radiograph. Objective: To evaluate the imaging findings and complications in cases of congenital cystic lung lesions with chest tube insertion and suggest the role of appropriate imaging for management of these patients. Materials and Methods: Chest radiographs and CT scans of children with congenital cystic lung lesions who had inadvertent chest tube insertion preoperatively were retrospectively reviewed for imaging appearances and complications. Results: Fifteen patients comprising 10 cases of congenital cystic adenomatoid malformation (CCAM) and 5 cases of congenital lobar emphysema (CLE) were included. Majority of the cases were infants. CCAM was misdiagnosed as complicated pneumatocele (n = 5) and pneumothorax (n = 5), while CLE was misdiagnosed as tension pneumothorax (n = 5) on the chest radiograph findings. Final diagnosis was made on CT and operative findings with histopathology. Complications noted were pneumothorax, hydropneumothorax, and infection in cases of CCAM, and change in imaging appearance and pneumothorax in cases of CLE. Conclusion: Chest tube insertion in congenital cystic lesions increases the rate of associated complications. Chest CT has a definite role in early diagnosis and deciding appropriate management in these cases.
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Affiliation(s)
- Shailesh M Prabhu
- Department of Radiodiagnosis, Lady Hardinge Medical College and Assoc. Kalawati Saran Childrens Hospital, New Delhi, India
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Spoel M, van de Ven KP, Tiddens HAWM, Hop WCJ, Wijnen RMH, Tibboel D, Ijsselstijn H. Lung function of infants with congenital lung lesions in the first year of life. Neonatology 2013; 103:60-6. [PMID: 23108035 DOI: 10.1159/000342224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 07/24/2012] [Indexed: 12/26/2022]
Abstract
BACKGROUND Several studies have evaluated short-term neonatal outcome in infants with congenital lung lesions (CLL) but clinical course and lung function in the longer term have not yet been documented. We hypothesized that clinical course and lung function would be negatively affected by surgical resection. OBJECTIVE To evaluate respiratory symptoms and lung function longitudinally in the first year of life in infants with CLL, and to analyse differences herein between infants managed by observation only and infants whose affected lung parts were resected. METHODS We evaluated respiratory symptoms and lung function at 6 and 12 months in 30 patients with CLL. Functional residual capacity (FRC(p)) and maximal expiratory flow at functional residual capacity (V'(max)FRC) were measured with body plethysmography. SD scores were calculated for V'(max)FRC. RESULTS Prevalence of respiratory symptoms did not differ between the groups. Mean FRC(p) (95% CI) was 25.3 (23.3-27.3) in the group managed by observation versus 27.3 (25.1-29.6) in the group managed by surgery (p = 0.149). Mean (95% CI) SDS V'(max)FRC was -1.45 (-1.84 to -1.06) versus -1.41 (-1.90 to -0.91) (p = 0.892). Lung function did not change significantly over the 6-month period. CONCLUSION Surgical resection did not seem to have negatively affected the clinical course and lung function. We recommend pulmonary follow-up of all CLL patients into adulthood to further identify any long-term effects of CLL and observation or surgery.
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Affiliation(s)
- Marjolein Spoel
- Intensive Care and Department of Pediatric Surgery, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands. m.spoel @ erasmusmc.nl
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Abstract
Congenital lobar emphysema (CLE) is a clinico-radiological diagnosis, seen usually by four-six weeks of age (50% of patients) and rarely (<5% of patients) after the age of six months. Here, we report a young male with gradual onset of mild exertional breathlessness and physical examination revealing the features of right sided pneumothorax. X-ray of chest, with subsequent CT of chest, leads to the diagnosis of CLE. The pulmonary function tests, bronchoscopic examination and α1-antitrypsin level are normal. Patient is managed conservatively.
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Affiliation(s)
- Mir Sadaqat
- Departments of Internal Medicine, Chest Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
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