Single-stage bilateral lobectomy for life-threatening bilateral congenital lobar emphysema in a 6-month-Old infant: A rare case report

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: Background Congenital lobar emphysema (CLE) is a rare lower respiratory tract developmental anomaly, characterized by hyperinflation of lung lobular tissue, causing compression atelectasis of adjacent lung segments and mediastinal displacement. While CLE typically involves a single lobe, most commonly the left upper lobe or right middle lobe, bilateral involvement is exceptionally rare. Case presentation A 6-month-old male patient presented to emergency department with progressive respiratory distress, tachypnea, subcostal retractions, recurrent chest infections and an SpO2 of 80% on room air. High-resolution CT of the chest demonstrated asymmetric hyperinflation and hyperlucency of the right middle lobe (RML) and the left upper lobe (LUL), with compressive atelectasis. Under general anesthesia with conventional single-lumen endotracheal intubation, a single-stage bilateral lobectomy was performed via sequential thoracotomies, starting with the right middle lobectomy followed immediately by the left upper lobectomy. Bilateral chest tubes were placed intraoperatively. The child was extubated on postoperative day 2, spent 10 days in the hospital, and showed complete resolution of symptoms with full lung re-expansion at the 6-month follow-up. Conclusion Single-stage bilateral lobectomy for bilateral CLE in infants may be safe and effective in selected cases.

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