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Congenital lobar overinflation

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis almost certain

Presentation

Infant with respiratory distress, cough, and reduced air entry.

Patient Data

Age: 3 months
Gender: Male
x-ray

The left upper lobe of the lung is hyperexpanded with mediastinal shift towards the right. A portion of the left lung is herniated across the midline.

Hyperinflation and poor vascularization of left upper lobe with contralateral mediastinal shift to the right side. Attenuated lobar bronchi to the left upper lobe. Subsequent mass effect in the form of mediastinal displacement to the right side. Findings are matching with congenital lobar overinflation of the left upper lobe.

Case Discussion

Congenital lobar overinflation (CLO), previously called congenital lobar emphysema, is a congenital lung abnormality that results in progressive overinflation of one or more lobes of a neonate's lung. It is more common in males (M:F = 3:1). The left upper lobe is the most commonly affected, 40-45%.

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