Congenital Lobar Emphysema

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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.

Echocardiogram

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: ★★☆