Congenital Lobar Emphysema


Step 1: View clinicals

A 26 day old boy presents with cough and coryza for 5 days, and dyspnea for 2 days. His 2 year old brother had an upper respiratory tract infection around 1 week ago. His antenatal, birth, and immediate postnatal histories are unremarkable.

Step 2: Order all relevant investigations

Chest X-Ray

The right upper lobe is collapsed, while the left upper lobe is markedly overdistended. The mediastinum is displaced towards the right.


The echocardiogram is normal.

Full Blood Count

WBC: 14,200/mm3 (6,000-18,000) Hb: 11.2 g/dL (9.4-13) Platelets: 336,000/dL (150,000-450,000)

CT Thorax

The left upper lobe is hyperlucent and grossly hyperinflated, while the left middle and right upper lobes are collapsed. There is significant mediastinal shift towards the right.

Step 3: Select appropriate management

IV Antibiotics
Intubation & Ventilation
High-flow Oxygen
Left Upper Lobectomy

Score: ★★☆