ABSTRACT
Background: congenital anomalies of the lung are rare disorders that can present by life threatening emergency which may need emergent thoracotomy
Aim: to evaluate our methods of investigations and emergent management of these life threatening problems
Patients and Methods: this study represents the experience of Cardio Thoracic Surgery Department in collaboration with General Surgery Department, Mansoura University Hospital, Mansoura, Egypt on 32 cases who needed emergent thoracotomy for different congenital lung anomalies. Thirty two Consecutive patients had emergent operations from January 1996 until December 2001
Results: eighteen patients had tension lung cysts, 11 patients had congenital lobar over inflation, 2 patients had sequestrated segment, and one patient had congenital arteriovenous malformation. There were 14 males and 18 females, the age ranged from 3 days up to 16 years [mean age4+/-4.2y]. Patients less than 2 years presented with dyspnea, tachypnea, cyanosis, and respiratory distress, while the older patients presented with chest pain, hemoptysis. Plain X-ray chest was sufficient for the diagnosis in 26 patients [81.25%], while CT chest was done in 23 patients [71.8%], bronchoscopy was also done in 6 patients [18.75 %] for exclusion of foreign body inhalation. Curative surgery was achieved by 28 lobectomies, 3 bilobectomies, and in one case by cyst enucleation. The complications were in the form of postoperative pneumonia, atelectasis, air leak and empyema in 14.5% of cases which managed easily. Infants and children tolerate lobectomy extremely well, with compensatory lung growth, so that total lung volume and gas exchange capacity returns to normal during somatic maturation
Conclusion : it is concluded from this study that these congenital lung malformations may cause respiratory distress and hemoptysis and need emergent thoracotomy which is curative. X-ray chest and CT scan are sufficient for accurate diagnosis. Emergent surgery is safe and curative in those patients as infants and children tolerate lung resection very well with compensatory lung growth during somatic maturation