%0 Journal Article
%T Report of an Exceptional Case of Lobar Emphysema in an Infant
%A M. Ashrafi
%A M. Bajaghli
%A M. Hosseinpour
%J Iranian Journal of Radiology
%D 2005
%I Tehran University of Medical Sciences
%X Introduction & Background: Congenital lobar em-physema is an illness characterized by an overdisten-tion of one or sometimes two lobes of the lung. The term 'lobar emphysema' is in fact a misnomer. In this lesion, the walls of the pulmonary alveoli are not de-stroyed; instead a ball-valve mechanism leads to bronchial obstruction. The causes of this obstruction include reduced bronchial cartilage, bronchial carti-lage dysplasia, inflammatory processes, thick sputum, bronchial mucosal webs, bronchial stenosis, and the pressure exerted by the vasculature on the bronchus. Most cysts develop in the upper lobe of the left lung, but both lobes of the left lung were involved in the present case. Case Report: A male infant with a birth weight of 1400g was born through cesarean section due to twin pregnancy. Due to prematurity and respiratory dis-tress, and with the diagnosis of hyaline membrane disease, treatment with surfactant was initiated for him. Patient weaned from the ventilator after 4 days, but was again connected to because of oxygen re-quirement. Breath sounds on the left gradually de-creased, and heart sounds were heard better on the right. Chest radiography showed primary radiolu-cency due to fluid retention in the lungs followed by a gradual emphysema appearance and mediastinal shift to the right and lung herniation to the opposite side in the form of double shadow. The respiratory problems got worse gradually. Therefore, the intra-tracheal tube was moved to the right to improve res-piration. Radiological signs were noticeable in serial chest radiographies. Surgical consultation was done for the patient, one month after the appearance of symptoms. Finally the patient underwent a thora-cotomy with the diagnosis of left lobar emphysema. Since both lungs were affected, total thoracotomy was done and pathology examination later confirmed the diagnosis of lobar emphysema. No concomitant abnormality was observed in this case.
%U http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/2210.pdf&manuscript_id=2210