Congenital emphysema: Mgmt

Pediatrics

On exam, these patients present with respiratory distress, tachypnea, oxygen desaturation and hyperinflation of the affected lung. Chest xray reveals a hyperinflated lobe of the lung. Vascular markings will help differentiate congenital emphysema from a pneumothorax. A CT scan may also be performed to further define the anatomy prior to surgical resection. The surgical resection is a lobectomy. This is typically performed through an open approach but there are reports of this being achieved thoracoscopically.

Postoperative analgesia can be achieved with a single injection caudal block or a caudally placed epidural catheter. Many of these patients can be extubated at the completion of surgery.

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2012

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