2018 Volume 54 Issue 4 Pages 927-934
Swyer-James syndrome (SJS) is a rare condition characterized by increased permeability of one pulmonary or lung lobe and loss of pulmonary blood vessel shadow in chest X-ray. Recently, the number of case reports of bilateral or patchy lesions have been increasing owing to the development of computed tomography (CT). We encountered a case of bilateral SJS in a 7-year-old boy and performed thoracoscopy-assisted pulmonary resection. The boy, who had histories of repeated pneumonia, bronchitis, asthma, and infection of a left apical lung cyst, was referred to our hospital. Chest CT showed lobar emphysema with multiple cysts in the left upper lobe and complete atelectasis in the left lower lobe, as well as whole expansion and patchy emphysema in the right lung, in addition to obstruction of the peripheral bronchus in the left upper lobe and narrowing of the left pulmonary vessels. Therefore, we diagnosed him as having SJS. We performed thoracoscopy-assisted partial resection of the left upper lobe and left lower lobectomy, considering ventilation failure due to recurrent cyst infection or shunt blood flow in complete atelectasis. He was discharged on the 15th postoperative day, and no rehospitalization due to respiratory tract infection or asthma attack occurred until 10 months after surgery. We should consider SJS in cases of repeated respiratory infections from the infantile period, and then consider lung resection if a patient suffers from infectious cyst formation or respiratory distress, even in childhood.
