Middle Lobe Atelectasis in Children

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Abstract
The bronchograms of 11 children with right middle lobe (RML) collapse were correlated with their clinical course and with the state of the resected lobes in 7 children who required middle lobectomy. Four children with bronchograms which showed bronchial stenosis, bronchiectasis, or both were treatment failures and required resection. All lobes were bronchiectatic and fibrotic. Two children with nonfilling of the middle lobe bronchus required resection with similar abnormality demonstrated. In five children with normal bronchograms expansion was restored in the middle lobe while receiving medical therapy. Only one child required resection for recurrent collapse and pneumonitis. The importance of the bronchogram in selecting patients for surgery is stressed and a diagnostic and therapeutic regimen is outlined.

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