Congenital lobar emphysema: problems in diagnosis and management.

A retrospective study was made of 9 patients with congenital lobar emphysema who presented over the past 13 years. The ages of the patients at diagnosis ranged from 2 weeks to 10 years. The earlier the presentation, the more severe were the symptoms. Two patients were misdiagnosed initially at the referring hospitals with near disastrous results. Pitfalls in diagnosis are outlined and the various investigative procedures discussed. A flow chart for the diagnostic approach is presented. Treatment was usually by lobectomy but 2 older children presenting late with mild symptoms were managed conservatively with satisfactory results.