Views/Visit: 893
Case 23 : Chest X ray: Right lung collapse with shift of mediastinal structures and trachea toward the affected side, diminished pulmonary vascularity on involved side Herniation of left lung across the mediastinum (compensatory) Increase radiolucency in the left hemithorax Elevated right hemidiaphragm, depressed contralateral diaphragm
พ.ท.หญิง พญ.สุพิชญา จึงจิตรักษ์
โรงพยาบาลพระมงกุฎเกล้า
Case 23 :
Chest X ray: Right lung collapse with shift of mediastinal structures and trachea toward the affected side, diminished pulmonary vascularity on involved side Herniation of left lung across the mediastinum (compensatory) Increase radiolucency in the left hemithorax Elevated right hemidiaphragm, depressed contralateral diaphragm
CT chest:: Complete absence of lung tissue on the right side with ipsilateral mediastinal shift Left lung was seen herniating to the opposite side due to compensatory hypertrophy Right pulmonary artery and bronchus were absent Pulmonary agenesis
Complete absence of a lung, it differs from aphasia in the absence of a bronchial stump. Bilateral pulmonary agenesis is incompatible with life, presenting as severe respiratory distress and failure Unilateral agenesis may have few symptoms and non-specific
findings. Right lung agenesis has higher morbidity and mortality than left lung agenesis: aorta can compress trachea or central airway compression Associate with other congenital anomalies; such as VACTERL sequence, ipsilateral facial, skeletal, cardiac malformation
Investigation: CT chest is diagnosis, bronchoscopy Conservative treatment is recommended Compensatory growth of remaining lung allows for improved gas exchange, but mediastinal shift can lead to scoliosis and airway compression
