Shafiqi Mohammad, Yama Mujtaba, Rayan Oranoos, Moghul Dunya
Department of Pediatric Surgery, Afghan Arya Complex Hospital, Herat, Afghanistan.
McGill University Faculty of Medicine and Health Sciences, Montreal, QC, Canada; Division of Pediatric Surgery, Montreal Children's Hospital, Montreal, QC, Canada.
Int J Surg Case Rep. 2025 Mar;128:111109. doi: 10.1016/j.ijscr.2025.111109. Epub 2025 Mar 3.
Congenital cystic adenomatoid malformation (CCAM) is a rare pulmonary anomaly typically diagnosed prenatally. In developing countries like Afghanistan, limited medical infrastructure leads to delayed diagnosis and improper treatment. This case highlights diagnostic challenges in resource-constrained settings.
A 3.5-month-old boy presented with respiratory distress, cough, fever, and tachypnea. Symptoms began at 15 days, with repeated ineffective pneumonia treatments. A pediatric surgeon's referral led to a chest CT scan revealing CCAM in the right lung's upper and middle lobes. The patient required oxygen and bronchodilators but avoided intubation. A right upper and middle lobectomy was performed, with discharge four days later.
This case illustrates challenges in diagnosing congenital lung anomalies in resource-limited environments. CCAM misdiagnosis as pneumonia underscores the need for comprehensive diagnostic approaches. Key observations include the necessity of advanced imaging, increased clinical awareness, and robust pediatric respiratory disease management. Healthcare providers must maintain high suspicion when treating recurrent respiratory conditions unresponsive to standard treatments.
Improving maternal healthcare access and diagnostic capabilities in low-income countries is crucial for timely CCAM detection. Addressing challenges requires expanding diagnostic capabilities, enhancing healthcare education, and investing in medical technologies. These improvements will ensure better patient outcomes in resource-constrained settings.
先天性囊性腺瘤样畸形（CCAM）是一种罕见的肺部异常，通常在产前被诊断出来。在阿富汗等发展中国家，有限的医疗基础设施导致诊断延迟和治疗不当。本病例突出了资源受限环境下的诊断挑战。
一名3.5个月大的男婴出现呼吸窘迫、咳嗽、发热和呼吸急促症状。症状始于15天，多次肺炎治疗均无效。经儿科外科医生转诊后进行胸部CT扫描，发现右肺上叶和中叶存在CCAM。患者需要吸氧和使用支气管扩张剂，但避免了插管。实施了右上叶和中叶切除术，四天后出院。
本病例说明了在资源有限的环境中诊断先天性肺部异常的挑战。CCAM被误诊为肺炎凸显了采用全面诊断方法的必要性。关键观察结果包括先进成像的必要性、提高临床意识以及加强儿科呼吸道疾病管理。医疗保健提供者在治疗对标准治疗无反应的复发性呼吸道疾病时必须保持高度怀疑。
改善低收入国家的孕产妇医疗服务可及性和诊断能力对于及时发现CCAM至关重要。应对挑战需要扩大诊断能力、加强医疗保健教育并投资于医疗技术。这些改进将确保在资源受限的环境中取得更好的患者治疗效果。
