Pneumonectomy in Congenital Lobar Emphysema: A Case Report

 Susan Hendriarini Mety, I Putu Kokohana Arisutawan, Muhammad Aris Furqon

Staff of Cardiothoracic and Vascular Surgery Department, Persahabatan Hospital, Jakarta, Indonesia

Abstract

Background: Congenital lobar emphysema is a rare congenital disease which caused by anomaly on bronchial cartilage development. Usually, it is limited to a single lobe. It could be treated conservatively or surgically depend on the clinical condition. In this case report we would like to discuss the management strategy for congenital lobar emphysema that affected the whole lung in 17 days old baby.

Case presentation: The patient was admitted to NICU due to respiratory distress. The patient had a difficulty to wean from ventilator. Radiologic examination revealed the whole left hemithorax is filled by multiple bullae which push mediastinal organ contralaterally. Intraoperatively, we found the whole left lung is emphysematous and there is PDA which is not detected preoperatively. Surgeon decided to do pneumonectomy and PDA ligation. After operation, patient recovered on NICU slowly and discharged from hospital 34 days post operation.

Discussion : our case of congenital lobar emphysema which affect one side of lung is a rare case. Our decision to do pneumonectomy was challenging post operatively.

Conclusion: Multidisciplinary team should be involved in treatment of congenital lobar emphysema. Team should be prepared for prolonged intensive care if decision to do lung resection is chosen.

Keywords: Congenital lobar emphysema, pneumonectomy, neonates