부산대학교 도서관

We report the case of a 41-year-old female with congenital bronchial atresia (CBA) in whom extensive inflammation led to incomplete lobulation. Her past medical history involved recurrent pneumonia in childhood. Chest MDCT showed B2 occlusion by the mucocele, and inflammatory changes were extensive in the peripheral lung fields of S2 and a part of the middle lobe, leading to incomplete lobulation of the lobes. We diagnosed her with CBA. We performed surgical treatment to prevent recurrent infectious pulmonary complications and long-term lung alteration. It was difficult to approach the interlobular fissure because the right upper lobe and middle lobe were indurated by chronic inflammation. Using a fissureless technique, we performed right upper lobectomy and partial resection of the middle lobe in accordance with preoperative simulation by MDCT. The postoperative course was uneventful. She has remained under follow-up for 2 years with no recurrence. The incomplete lobulation and chronic recurrent inflammation in CBA make surgery approaching an interlobular fissure difficult. Images by MDCT are important to diagnose CBA, evaluate preoperative inflammation, and simulate the operation carefully.