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Apical Lung Herniation Associated with Continuous Positive Airway Pressure in a 4-Year-Old Girl

Christopher J Lehmann1, Ameet S Daftary2, Evans M Machogu2

  • 1Indiana University School of Medicine, Internal Medicine and Pediatrics Residency, Indianapolis, IN.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|July 12, 2016
PubMed

Insights

A rare case of apical lung herniation occurred in an obese child using continuous positive airway pressure (CPAP) for sleep apnea. The lung hernia resolved after discontinuing CPAP therapy.

Area of Science:

  • Pulmonology
  • Pediatric Medicine
  • Radiology

Background:

  • Lung herniation is a rare condition typically associated with congenital thoracic abnormalities or trauma causing increased intrathoracic pressure.
  • Continuous positive airway pressure (CPAP) is a common treatment for obstructive sleep apnea, particularly in obese patients.

Observation:

  • A case study involving an obese child hospitalized for community-acquired pneumonia and treated with nocturnal CPAP for obstructive sleep apnea.
  • An incidental finding of apical lung herniation through the superior thoracic aperture was noted on routine follow-up chest radiography.

Findings:

  • The apical lung herniation was directly associated with the use of nocturnal CPAP therapy.
  • Cessation of CPAP treatment led to the resolution of the lung hernia.

Implications:

  • This case suggests a potential, previously undescribed association between CPAP use and lung herniation in pediatric patients.
  • Further investigation is warranted to understand the mechanism and risk factors for CPAP-induced lung herniation.

Keywords:
continuous positive airway pressurelung herniaobstructive sleep apneapulmonary herniasleep-disordered breathing

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