CONGENITAL LOBAR EMPHYSEMA IN A 9-MONTH-OLD INFANT: ANAESTHETIC CHALLENGES

Congenital lobar emphysema is a rare congenital lung malformation which can become symptomatic at birth or later. Most patients present with symptoms before the age of six months, with the majority having symptoms at an early age. The etiology is mainly the overinflation of the lobe due to defective development of bronchial cartilages, which can further lead to compression atelectasis and respiratory distress. Congenital lobar emphysema often presents as a diagnostic and therapeutic dilemma. The treatment modality of choice in severe cases is lobectomy. Prompt suspicion will help diagnose congenital lobar emphysema and timely management can be life saving. A lobectomy poses various challenges to anesthesiologists. The use of muscle relaxants to aid tracheal intubation after induction, one lung ventilation, and positive pressure ventilation with close monitoring of lung dynamics may be useful. We report a case of nine-month-old-infant of CLE who underwent right upper lobectomy and the anaesthetic challenges experienced during the case.