The follow-up was resumed at around 7 months and 15 days of age with the persistence of the above complaints. He had several admissions at another healthcare facility. He continued to grow poorly with a weight of 5.1 kgs. and a length of 62 cms. On repeat X-ray chest evaluation, hyperlucency of the right middle lobe and crowding of both the right upper and lower lobe was noted. (Figure 2)
Figure 2 X-ray chest Postero-anterior (PA) view showing clear hyperluceny of the right middle lobe with crowding of right upper and lower lobe with mediastinal shift. Sternal wires from the previous heart surgery can be made out.
CT scan confirmed the presence of Congenital Lobar Emphysema involving the right middle lobe. (Figure 3,4)