title: Unilateral Obstructive Emphysema in Infancy due to Mediastinal Bronchogenic Cyst-Diagnostic Challenge and Management.
abstract: Bronchogenic cysts are the most common cystic mediastinal lesion in children. Bronchogenic cyst causing unilateral obstructive emphysema is a rare presentation. We report the case of a one and half month old infant who presented with respiratory distress which was initially suspected as left pneumothorax on frontal chest radiograph but was later found to be due to hyperinflated left lung and hence the possibility of congenital lobar emphysema was considered. CT thorax and limited MRI sections revealed a cystic lesion in mediastinum causing obstructive emphysema and mediastinal displacement. He underwent an emergency thoracotomy and excision of the cyst via an extrapleural approach. Post operatively, rapid improvement of the infant was noticed both clinically as well as radiologically. Cross sectional imaging like CT or MR is required for reaching the correct and early diagnosis in paediatric patients with respiratory distress, when there is diagnostic dilemma based on chest radiograph.
authors.affiliation: Assistant Professor, Department of Radiology, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Leena Robinson
authors.initials: LR
authors.lastname: Vimala
authors.affiliation: Associate Professor, Department of Pediatric Surgery, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Ravi Kishore Barla Sri
authors.initials: RK
authors.lastname: Sathya
authors.affiliation: Assistant Professor, Department of Pediatrics, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Arul Premanand
authors.initials: AP
authors.lastname: Lionel
authors.affiliation: Resident, Department of Pediatric Surgery, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Jeenapalli Srinivasa
authors.initials: JS
authors.lastname: Kishore
authors.affiliation: Resident, Department of Pediatrics, Christian Medical College , Vellore, Tamil Nadu, India .
authors.forename: Kirubakaran
authors.initials: K
authors.lastname: Navamani
keywords: Cystic lesion; Mediastinal displacement; Respiratory distress