Nelson Textbook of Pediatrics 22nd Edition | Pulmonary emphysema = irreversible alveolar septal disruption. Overinflation = distention without rupture (reversible). Localized: congenital lobar emphysema (CLE) - left upper lobe most common, presents with respiratory distress in neonates/infants, treatment lobectomy. Swyer-James syndrome (unilateral hyperlucent lung after infection). Bullous emphysema. Generalized: asthma, bronchiolitis, CF. Clinical: hyperresonance, decreased breath sounds, mediastinal shift (with tension). Imaging: hyperlucent lung, air trapping. Subcutaneous emphysema: crepitus, self-limited.
๐ paeds.online โ Pakistan's Pediatric Platform| Condition | Key Features | Treatment |
|---|---|---|
| Congenital lobar emphysema (CLE) | Left upper lobe most common, neonatal respiratory distress, mediastinal shift, hyperlucent lobe | Observation if mild; lobectomy if severe (cyanosis, FTT, respiratory failure) |
| Swyer-James syndrome | Unilateral hyperlucent lung after infection (adenovirus), decreased perfusion | Observation, treat infections, pulmonary rehab if symptomatic |
| Generalized overinflation | Asthma, bronchiolitis, CF, BPD | Treat underlying disease (bronchodilators, steroids, airway clearance) |
| Subcutaneous emphysema | Crepitus on palpation, self-limited, associated with pneumomediastinum/pneumothorax | Resolves spontaneously; treat underlying air leak |