Congenital emphysema: Mgmt
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.