Related Experiment Video
Updated: May 3, 2026
Development of Obliterative Bronchiolitis in a Murine Model of Orthotopic Lung Transplantation
Published on: July 10, 2012
Surgical salvage of acquired lung lesions in extremely premature infants
Greg D Sacks1, Katherine Chung, Kevin Jamil
1Division of Pediatric Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, P. O. Box 709818, Los Angeles, CA, 90095-7098, USA.
Insights
Acquired neonatal lung lesions can compress the mediastinum, impacting infant heart and lung function. Surgical intervention may be necessary for severe cases unresponsive to medical management.
Area of Science:
- Neonatal Medicine
- Pediatric Surgery
- Pulmonology
Background:
- Acquired neonatal lung lesions, such as pneumatoceles and cystic bronchopulmonary dysplasia, can lead to extrinsic mediastinal compression.
- This compression may compromise pulmonary and cardiac function in neonates.
Observation:
- A case series of three extremely premature infants with acquired lung lesions is presented.
- All infants initially received aggressive medical management.
- Despite medical treatment, all patients ultimately required tube thoracostomies, which were unsuccessful, necessitating emergency thoracotomies.
Findings:
- Two infants with acquired pneumatoceles underwent surgical unroofing of cystic structures and primary repair of bronchial defects.
- The third infant, diagnosed with pulmonary interstitial emphysema secondary to cystic bronchopulmonary dysplasia, required a middle lobectomy due to diffuse cystic disease.
Implications:
- Medical management is the primary approach for acquired neonatal lung lesions.
- Tube thoracostomy may be attempted for refractory cases.
- Surgical options, including bronchial defect repair or lung resection, are reserved for persistent or severe conditions unresponsive to less invasive treatments.
Abstract:
Acquired neonatal lung lesions including pneumatoceles, cystic bronchopulmonary dysplasia, and pulmonary interstitial emphysema can cause extrinsic mediastinal compression, which may impair pulmonary and cardiac function. Acquired lung lesions are typically managed medically. Here we report a case series of three extremely premature infants with acquired lung lesions. All three patients underwent aggressive medical management and ultimately required tube thoracostomies. These interventions were unsuccessful and emergency thoracotomies were performed in each case. Two infants with acquired pneumatoceles underwent unroofing of the cystic structure and primary repair of a bronchial defect. The third infant with pulmonary interstitial emphysema, arising from cystic bronchopulmonary dysplasia, required a middle lobectomy for severe and diffuse cystic disease. When medical management fails, tube thoracostomy can be attempted, leaving surgical intervention for refractory cases. Surgical options include oversewing a bronchial defect in the setting of a bronchopleural fistula or lung resection in cases of an isolated expanding lobe.
