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  1. Katherine Jane Pettinger1,
  2. David Crabbe2
  1. 1Paediatric Intensive Care Unit, Leeds General Infirmary, Leeds, UK
  2. 2Department of Paediatric Surgery, Leeds General Infirmary, Leeds, UK
  1. Correspondence to Dr Katherine Jane Pettinger, Paediatric Intensive Care Unit, Leeds General Infirmary, Leeds LS1 3EX, UK; k.pettinger{at}doctors.org.uk

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  1. The chest radiograph shows volume loss in both lower lobes and right upper lobe. The right middle lobe is overinflated. There is mediastinal shift to the left.

    These findings were present on earlier radiographs, but their persistence was particularly significant.

  2. In view of the continuing oxygen requirement and the persistent changes on chest radiographs, a chest CT scan should be organised to evaluate further.

    In this baby’s case, congenital lobar overinflation (previously known as congenital lobar emphysema) of the right middle lobe was demonstrated (figure 2).

  3. The baby should be referred to the surgical team for evaluation. In mild cases, conservative management …

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