Analysis of the Etiologies, Radiologic Findings, Bronchoscopic Findings, and Clinical Courses of Right Middle Lobe Syndrome in Children.
- Author:
Yu Jin KIM
1
;
Dong Kil YOU
;
Hwa Young PARK
;
Jae Min CHO
;
Yong Min PARK
;
Mee Yong SHIN
;
Kang Mo AHN
;
Sang Il LEE
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea. kmaped@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Right middle lobe syndrome;
Pneumonia;
Tuberculosis;
Asthma;
Bronchoscopy;
Atelectasis
- MeSH:
Asthma;
Bronchi;
Bronchiectasis;
Bronchoscopy;
Child*;
Cough;
Early Diagnosis;
Follow-Up Studies;
Humans;
Lung;
Medical Records;
Middle Lobe Syndrome*;
Pneumonia;
Pulmonary Atelectasis;
Radiography;
Retrospective Studies;
Thorax;
Tuberculosis
- From:Pediatric Allergy and Respiratory Disease
2004;14(4):342-349
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Right middle lobe syndrome is defined as chronic atelectasis of the middle lobe of the right lung. The purpose of this study was to analyze the etiologies, radiologic findings, bronchoscopic findings, and clinical manifestations of right middle lobe syndrome in children. METHODS: We retrospectively reviewed the medical records of 28 children, who were admitted to the Samsung Medical Center from June 1998 to January 2003. These children had persistent atelectasis in the right middle lobe in plain chest radiography for more than a month. RESULTS: In 28 children, the most common etiology was pneumonia, followed by tuberculosis, bronchiectasis, and asthma. Most of the patients manifested nonspecific respiratory symptoms, such as coughing. The computerized tomography showed various findings including atelectasis, air bronchogram, or bronchietasis. While normal patent airway was found in 50% of the patients by bronchoscopy, narrowing of bronchus, large amount of secretion, and granulation nodules were noted in another half of the patients. In comparison with tuberculosis, atelectasis caused by pneumonia was relived more frequently by bronchoscopic therapeutic intervention (P=0.008), but there was no significant difference between them after approximately 2 years of follow-up. (P=0.232) Final outcomes in patients whose duration of atelectasis was 2 months or less tended to be better than 12 months or more, but it was not statistically significant. (P= 0.067) CONCLUSION: Common causes of right middle lobe syndrome in Korean children are pneumonia and tuberculosis. A high index of suspicion is required for early diagnosis and proper treatment which leading to better outcomes.
