Congenital lobar overinflation

Case contributed by Hani M. Al Salam
Diagnosis almost certain

Presentation

Pediatric patient with recurrent chest infection and respiratory distress.

Patient Data

Age: 1 month old

Chest x-ray

x-ray

Chest radiographs demonstrate increased translucency of the left lung with mild mediastinal shift to the right side. On the lateral projection, the hyperlucency is confined to the left upper lobe, shifting the oblique fissure posteroinferiorly. 

Annotated chest x-ray

Annotated image

The hyperinflated lobe (outlined in blue) can be seen to displace the oblique fissure and the mediastinum. 

Case Discussion

Findings are consistent with left upper lobe congenital emphysema, currently called congenital lobar overinflation.

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