Lobes congenital emphysema

Lobes congenital emphysema (synonym: hypertrophic disease of the newborn, equity obstructive emphysema, bronhialny emphysema) is observed in newborns and children of the first months of life. The Genesis lobes of emphysema is not clear. Most authors consider that it is based on a valve mechanism at the expense of malformation of the bronchi and bronchioles. Violation of bronchial obstruction may be due to absence or hypoplasia of the cartilage elements, with folding excessively developed the mucous membrane of the bronchi. The emergence lobes emphysema possible due to compression of the bronchus outside abnormally positioned vessel (arterial duct, arterial bundle or the pulmonary artery). Some authors consider the reason lobes emphysema loss of elasticity of the lung parenchyma in the presence of alveolar hyperplasia.
The clinical picture of congenital lobes emphysema is manifested in the neonatal period in the form of breathing problems arising in the result of the compression swollen shares healthy areas of the lung as on the affected side, and on the other due to the displacement of mediastinum. The severity of respiratory disorders vary extremely. If acute respiratory failure occurs with the first birthday, she quickly attached cardiovascular collapse, and the child dies quickly. More respiratory disorders occur in the first 3-4 weeks of life gradually; they come in the form of apnea, cyanosis, increasing during feeding or discomfort to the child. Often marked attacks asphyxia with noisy, rattling breathing and convulsions due to acute hypoxia. Physical data (weakening of breath, sound box on the affected lobe etc) in newborns often questionable and not of crucial importance for diagnosis.
Depending on the degree of violation of bronchial passability and compensatory abilities of the child respiratory disorders may have different course. In the absence of inflammatory changes in the lungs or atelectasis symptoms lobes emphysema develop slowly, over several months. But in these cases without radical treatment of the child may be killed during one of the attacks of asphyxia.
All described the clinical symptoms in the newborn may occur for a variety of diseases - diaphragmatic hernia, hard cyst lung, pneumothorax, tumors and cysts of the mediastinum, abnormal development of blood vessels, therefore decisive for the diagnosis lobes of emphysema are the data of x-ray studies. This reveals a sharp increase in the affected lobe (swelling). Pulmonary the drawing is almost not observed, there is polarisavenue affected share on the healthy side, the sharp shift of the heart and the flattening of the dome of the diaphragm limit its tours.
In difficult cases, have to resort to additional methods of research and first of all for tomography (E. A. Stepanov) and bronhografii.
Treatment lobes of emphysema can be only surgical - removal emphysematous a lobe of the lung; if respiratory distress grows, the intervention should be performed immediately after diagnosis lobes of emphysema.