Lobar Emphysema 2 (Differential Diagnosis RDS)

Chest radiograph at the age of 3 months after a progressive respiratory syndrome starting in the neonatal period immediately prior to surgery (left figure) and at the age of 12.3 years postoperatively (right figure). The heart is only visible in the right hemithorax; notice the left hemithorax with lack of lung structures. 12 years later, the heart shadow and the lung structures are normal, but the left hemithorax is much smaller than the right. By the age of three months the already present lobar emphysema of the left upper lobe has led to a total atelectasis of the residual left lung, to a herniation of parts of the left upper lobe (rounded zone above the heart shadow on the right side), and to a shift of the mediastinum. Postoperatively, the left hemithorax is smaller due to the excised upper lobe, and the place is occupied by the residual left lung.