J Korean Pediatr Soc.  2000 Jan;43(1):133-133.

Flexible Bronchoscopic Finding of Congenital Lobar Emphysema

Affiliations
  • 1Department of Pediatrics, Asan Medical Center, Ulsan University.
  • 2Department of Diagnostic Pathology, Asan Medical Center, Ulsan University.

Abstract

Congenital lobar emphysema is a rare disease and a cause of respiratory distress in early infancy. The most common location of pulmonary involvement is the left upper lobe. We diagnosed a case of congenital lobar emphysema in a 5-month-old female infant, who had a complex heart disease using flexible bronchoscopy. In spite of palliative heart surgery, respiratory difficulty and cyanosis did not improve and weaning from artificial ventilation was not possible. Chest X-ray and CT scan showed persistent hyperinflation in the left upper lobe. So, we performed flexible bronchoscopy. The findings showed no cartilage and patent bronchus during inspiration, but complete collapse during expiration due to a check valve effect in the left upper lobar bronchus. After excision of the involved lobe, the patient improved from respiratory distress. The observed airway patency during inspiration, and dynamic airway collapse on expiration suggest that bronchomalacia contributed to lung overinflation in this case.

Keyword

Congenital lobar emphysema; Flexible bronchoscopy; Bronchomalacia; Dynamic air way collapse

MeSH Terms

Bronchi
Bronchomalacia
Bronchoscopy
Cartilage
Cyanosis
Emphysema*
Female
Heart Diseases
Humans
Infant
Lung
Rare Diseases
Thoracic Surgery
Thorax
Tomography, X-Ray Computed
Ventilation
Weaning
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