Hanžič Nina, Čizmarević Urban, Žerdin Matija
Radiology, University Medical Centre Maribor, Maribor, SVN.
Cureus. 2019 Oct 3;11(10):e5830. doi: 10.7759/cureus.5830.
Congenital lobar overinflation (CLO) is a rare neonatal developmental anomaly. We present the case of a newborn boy who was born as a first twin at the 26th gestation week, and transferred to the department of pediatric intensive care due to respiratory distress and prematurity. Recurrent pneumothoraces were observed, and the chest drain was inserted. However, saturation was unsatisfactory although he was intubated and ventilated by synchronized intermittent-mandatory ventilation (SIMV). The chest radiographs showed hyperinflation of the right middle lobe, with mediastinal shift to the left, and atelectasis of the remaining lobes. That caused ventilation and perfusion mismatch and hypoxia, due to a decrease in ventilated lung tissue. When high-frequency ventilation was instituted, he stabilized. Computed tomography (CT) of the chest revealed the cause and the diagnosis of CLO was made. A high index of suspicion is needed when clinical and radiological findings are present in a newborn with respiratory distress and recurrent pneumothoraces to ensure prompt diagnosis and optimal, timely treatment.
先天性肺叶过度充气（CLO）是一种罕见的新生儿发育异常。我们报告一例新生儿男婴，他是第26孕周出生的双胞胎中的老大，因呼吸窘迫和早产转入儿科重症监护病房。观察到反复发生气胸，并插入了胸腔引流管。然而，尽管通过同步间歇指令通气（SIMV）进行了插管和通气，血氧饱和度仍不理想。胸部X线片显示右中叶过度充气，纵隔向左移位，其余肺叶肺不张。由于通气的肺组织减少，导致通气与血流不匹配和缺氧。当采用高频通气时，他的病情稳定下来。胸部计算机断层扫描（CT）揭示了病因，从而做出了CLO的诊断。对于有呼吸窘迫和反复气胸的新生儿，当出现临床和放射学表现时，需要高度怀疑，以确保及时诊断和进行最佳、适时的治疗。
