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Cirugía paraguaya

versión On-line ISSN 2307-0420


MOLINAS, Fernando et al. CONGENITAL LOBAR EMPHYSEMA: REPORT OF TWO CASES AND REVIEW OF THE LITERATURE. Rev. Cir. Parag. [online]. 2012, vol.36, n.1, pp.37-40. ISSN 2307-0420.

SUMMARY Introduction: congenital lobar emphysema is the abnormal distention of the lungs parenchyma. Its usual clinical manifestation appears at a short age, especially during the first months of life. The most frequent clinical presentation is a respiratory distress of increasing intensity. The imaging studies, that are chest radiograph and CT scan of the lungs, can make the diagnosis. Then a proper therapeutic procedure can be selected and applied. Lobectomy of the affected pulmonary lobe remains as the most effective therapy. The pathology studies confirm the diagnosis. Objectives: report two cases of congenital pulmonary emphysema affecting two nurslings of 7 and 2 months old, respectively. A special care is considered when presenting the information regarding the clinical presentation, the treatment applied and the pathology confirmation. Results: two nurslings patients where admitted to the pediatric emergency service presenting with respiratory distress. One of them had fever and VDRL 1:64 so antibiotics were used. The infection was managed but the respiratory distress persisted. In both cases, chest radiograph showed a radiolucent image on the affected area. CT scan of the lungs confirmed the disease in both cases. Lobectomy was performed as treatment. The pathology study confirmed both diagnoses. Conclusion: congenital lobar emphysema is an illness always to be considered among the probable diagnoses when dealing with a nursling affected by respiratory distress and presenting with a radiolucent image. A delay on the diagnosis should be avoided as the surgical removal of the affected lobe is the only effective therapy and must be done as quickly as possible to avoid death, especially when dealing with patients showing marked respiratory distress.

Palabras clave : Nursling; respiratory distress; radiolucency; enlarged airspaces; lobectomy.

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