The natural history of bronchial atresia. Serial observations of a case from birth to operative correction.

A 10-year-old child presented with a history of intermittent respiratory symptoms since birth. Progressive shift of the mediastinum away from a hyperexpanded left upper lobe to the right side was evident on serial chest films, since birth. Bronchograms demonstrated atresia of the bronchus to the hyperexpanded segment. Xenon washout demonstrated prolonged half-time in the left upper lobe resulting from collateral ventilatory channels. Resection of the apical posterior segment of the left upper lobe was performed without complication. Bronchial atresia with collateral ventilation caused "lobar emphysema" in this patient.