Current Thoracic Surgery

Congenital lobar emphysema (CLE) is a rare developmental anomaly of the lower respiratory tract, which generally presents during the neonatal/pediatric period. Lobectomy is the only curative treatment for CLE. An 18-year-old male with enlarging left anterior chest wall deformity and progressive breathlessness for the last 2 years admitted to our clinic.

Physical examination revealed asymmetrical expansion of left hemithorax. Chest radiography and thoracic computed tomography demonstrated hyperinflation of the left upper lobe and a mediastinal shift to the right side. FEV1 was 1.70 L (50%). Ventilation-perfusion scintigraphy showed reduced perfusion and ventilation in the right lung to 33.4% (upper zone, 1.9%; middle zone, 10.0%; lower zone, 22.5%). Patient underwent a successful video-assisted thoracoscopic surgery (VATS) left upper lobectomy, and was discharged on postoperative day 5. He is still being followed-up on fifth year, asymptomatically, with normalized chest wall appearance. VATS lobectomy is a feasible, safe and effective treatment for congenital pulmonary disorders, even for delayed cases.