Case Report
A 30-year-old pregnant female with an unremarkable surgical, medical,
drug or family history presented in the 13th week of gestation for a
routine Ultrasound (US) examination which revealed a cystic formation in
the left lung of the fetus associated with mild polyhydramnios. The
patient was asymptomatic and physical examination was unsignificant, By
monitoring, and during the 23rd and 26th weeks of gestation, the lesion
was stable and there was a slight increase in the amniotic liquid
(Fig.1). In the 39th week of gestation, the woman underwent caesarean
delivery and had a 3400 g weighing male who was admitted to the neonatal
intensive care unit by their parents and referred to the Department of
Pediatric Surgery complaining from severe respiratory distress worsening
during lactation, and it was decided to stay in the incubator for 24
hours. The chest radiography indicated the deviation of the mediastinal
structures toward the right-side Fig.2 (A). Chest radiography with oral
contrast excluded the presence of diaphragmatic hernia Fig.2 (B). At the
age of 14 days, a (computed tomography) CT scan of the chest with
contrast was performed and the diagnosis of CPAM was confirmed at the
expense of the lower left lobe (Fig.3). Except for the right axis
deviation, echocardiography did not indicate any cardiac abnormalities.
Upon completion of preoperative procedures, the 14-day-old patient
underwent an open left lower lobectomy via a left posterior thoracic
approach (Fig.4), and pathology studies of the resected part confirmed
the diagnosis of CPAM. The infant received post-operative care with
incubation for 3 days. On the third day after the operation, chest
radiography demonstrated the return of mediastinum to the midline, and a
compensatory hyperinflation of the residual lobes of the left lung.
Finally, the infant weaned off the respiratory support and was
discharged home at the age of 17 days without any complications. During
follow-up, the infant’s condition was found to be satisfactory.