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Master Thesis

Emphysème lobaire fœtal : à propos de 21 observations

Abstract : Introduction: Congenital Lobar Emphysema (CLE) is a rare anomaly of lung development, and is characterized by progressive lobar overexpansion. It may present in different forms varying from an incidentally found on images studies in an asymptomatic children, to a life-threatening acute neonatal respiratory emergency. Currently, the majority of lesions are detected in utero during the routine mid trimester US screening and called fetal lobar emphysema (FLE). There is a loss of prenatal factors predictive for birth respiratory distress, because of the rarity of the anomaly and the lack of large prospective studies. Method and material: We retrospectively reviewed from January 1999 to December 2012, in the Grenoble university hospital, all cases of FLE. We analyze the prenatal sonographic features, postnatal management, clinical, surgical and radiological presentation at birth, and final pathological examination. We performed an extensive literature review. Results: Twenty one fetuses were diagnosed with hyperechoic mass. Four patients developed a respiratory failure of which 2 requiring an emergency surgery within the first days of life. Both cases underwent an early surgery had lesion involving the left upper lobe. A total of 10 children need surgery, for lesion become symptomatic or for doubt diagnosis. It seems that the detection by MRI of a mediastinal shift is predictive of early respiratory distress, but no statistically significant. All children are doing well, with no mortality and a low rate of morbidity. Conclusion: Fetal lobar emphysema needs a prenatal screening management and a specialized neonatal evaluation. The prenatal risk factors must allow the birth in a tertiary care center having ability to perform a suitable treatment.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01225719
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Submitted on : Friday, November 6, 2015 - 3:49:56 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:18 AM
Long-term archiving on: : Monday, February 8, 2016 - 1:00:31 PM

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  • HAL Id : dumas-01225719, version 1

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Pierre-Yves Rabattu. Emphysème lobaire fœtal : à propos de 21 observations. Médecine humaine et pathologie. 2015. ⟨dumas-01225719⟩

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