Clinical and surgical aspects of congenital lobar over-inflation: a single center retrospective study.
BACKGROUND
Congenital lobar overinflation (CLOI) is one of the most important causes of infantile respiratory distress (RD). We aim to evaluate our experience in CLOI management emphasizing on clinical features, diagnostic modalities, surgery and outcomes.


METHODS
This is a retrospective study for all CLOI cases undergoing surgical management at Qena University Hospital. Demographic data, clinical data, radiographic findings, surgery and postoperative follow-up were reviewed.


RESULTS
A total of 37 neonates and infants with CLOI were presented to our center between January 2015 and January 2019; their mean age was 111.43 ± 65.19 days and 22 were males. All cases presented with RD; and cyanosis in 19 cases. 15 cases presented with recurrent pneumonia and fever. Diminished breath sounds on the affected side and wheezes were the main clinical findings in 30 and 22 cases respectively. On CXR, emphysema was detected in all cases. A confirmatory CT chest was done for all cases. Left upper lobe was affected in 23 cases, right middle lobe in 7 and right upper lobe in 7 cases. Lobectomy was done in thirty-one cases; their mean age at surgery was 147.58 ± 81.49 days and 19 were males. Postoperative complications were noted in 5 cases and postoperative ventilation was required for 2 of them. No morbidity or mortality was reported. The follow-up duration ranged from 3 months to 1 year and all patients were doing well except one case that lost follow up after 3 months.


CONCLUSION
CLOI is a rare bronchopulmonary malformation that requires a high index of clinical suspicion, especially in persistent and recurrent infantile RD. CT chest is the most useful diagnostic modality. Early management of CLOI improves outcome and avoid life-threatening complications. Surgical management is the treatment of choice in our center without recorded mortality.
['Abdel-Bary|Mohamed|M|https://orcid.org/0000-0002-7734-9089', 'Abdel-Naser|Mohamed|M|https://orcid.org/0000-0002-3798-2322', 'Okasha|Ahmed|A|', 'Zaki|Mohammed|M|', 'Abdel-Baseer|Khaled|K|https://orcid.org/0000-0002-5761-0614']
D001980:Bronchi D005260:Female D005500:Follow-Up Studies D006785:Hospitals, University D006801:Humans D007223:Infant D007231:Infant, Newborn D008168:Lung D008297:Male D011183:Postoperative Complications D011184:Postoperative Period D011656:Pulmonary Emphysema D012119:Respiration D012127:Respiratory Distress Syndrome, Newborn D012131:Respiratory Insufficiency D012135:Respiratory Sounds D012189:Retrospective Studies D013909:Thorax D014057:Tomography, X-Ray Computed
Congenital lobar overinflation Lobectomy Neonatal respiratory distress