Lung agenesis in a neonate presenting with contralateral mediastinal shift.

Area of Science:

• Neonatal Medicine
• Pediatric Radiology
• Congenital Anomalies

Background:

• Congenital lung agenesis is a rare condition.
• Neonatal respiratory distress necessitates prompt diagnosis.
• Typical mediastinal shift is ipsilateral in lung agenesis.

Observation:

• A neonate presented with right lung agenesis and respiratory distress.
• Radiological imaging revealed contralateral mediastinal shift and diaphragmatic eventration on the affected side.
• Intrathoracic hepatic herniation under an elevated diaphragm caused the contralateral mediastinal shift.

Findings:

• The combination of contralateral mediastinal shift and diaphragmatic eventration is a novel radiological presentation for lung agenesis.
• This case highlights atypical radiological signs associated with lung agenesis.
• Differential diagnoses for neonatal respiratory distress with mediastinal shift were discussed.

Implications:

• Increased clinical suspicion is crucial for diagnosing lung agenesis, especially with atypical presentations.
• Understanding these rare radiological features can aid in earlier diagnosis and management.
• Awareness of associated mortality factors in neonates with lung agenesis is important for improved outcomes.