Rollan V, Sanz N, Alvarez M, Sequeiros A, Gimeno M
Servicios de Cirugía Pediátrica, Hospital del Niño Jesús, Universidad Autónoma de Madrid.
Cir Pediatr. 1994 Apr;7(2):105-7.
Middle lobe syndrome (MLS) or atelectasis syndrome can affect any pulmonary lobe but occurs more frequently in the right middle lobe. Only 15 per cent of the reported cases are children. We report two cases of MLS in two boys of 4 and 12 years of age who were referred to our institution because they had suffered from recurrent pneumonies of the right middle lobe for ten months and six years respectively. We performed chest radiographs, computed tomography scanning, ventilation-perfusion scintigraphy and flexible bronchoscopy. The evolution in both cases to an atelectasic middle lobe with pulmonary shrinkage and lack of perfusion was the indication to lobectomy. Histological examination showed a bronchial obstructive process in the young patient and a chronic non specific inflammation of the pulmonary parenchyma in both. The resection brought about a cure. The identification of MLS is usually a late diagnosis. Thus, if atelectasis persists after an adequate medical therapy, resection of the lobe is indicated.
中叶综合征（MLS）或肺不张综合征可累及任何肺叶，但更常见于右中叶。报告病例中仅15%为儿童。我们报告了两例中叶综合征病例，两名男孩分别为4岁和12岁，因分别患有右中叶反复肺炎10个月和6年而转诊至我院。我们进行了胸部X光检查、计算机断层扫描、通气灌注闪烁扫描和纤维支气管镜检查。两例病例均演变为肺叶不张伴肺实质萎缩和灌注缺失，这是进行肺叶切除术的指征。组织学检查显示年轻患者存在支气管阻塞过程，两例患者均有肺实质慢性非特异性炎症。手术切除带来了治愈。中叶综合征的确诊通常较晚。因此，如果在充分的药物治疗后肺不张仍持续存在，则需进行肺叶切除。
