Background: Chest tube insertion in congenital cystic lung lesions is an important problem in children with acute respiratory distress having a cystic lucent lesion on chest radiograph. Objective: To evaluate the imaging findings and complications in cases of congenital cystic lung lesions with chest tube insertion and suggest the role of appropriate imaging for management of these patients. Materials and Methods: Chest radiographs and CT scans of children with congenital cystic lung lesions who had inadvertent chest tube insertion preoperatively were retrospectively reviewed for imaging appearances and complications. Results: Fifteen patients comprising 10 cases of congenital cystic adenomatoid malformation (CCAM) and 5 cases of congenital lobar emphysema (CLE) were included. Majority of the cases were infants. CCAM was misdiagnosed as complicated pneumatocele (n = 5) and pneumothorax (n = 5), while CLE was misdiagnosed as tension pneumothorax (n = 5) on the chest radiograph findings. Final diagnosis was made on CT and operative findings with histopathology. Complications noted were pneumothorax, hydropneumothorax, and infection in cases of CCAM, and change in imaging appearance and pneumothorax in cases of CLE. Conclusion: Chest tube insertion in congenital cystic lesions increases the rate of associated complications. Chest CT has a definite role in early diagnosis and deciding appropriate management in these cases.
Oh, I am old and hoar! so old that none
Of all my drops holds memory of birth:
My mists no longer rise to robe the Sun,
No longer lend great rivers to the Earth.
Low in my deeps my broken creatures die,--
They die! and their corruption loads my floors;
Countless and cold, my lordly monsters lie
On league-long sands of continental shores.
Where bide you, O white stallions of the waves?
And you torrential surges,--where the crest
You flung on leaping mountains that you drave
Across your father's fields from East to West?
Shine forth, O Moon! unveil thee, pallid queen!
Heal me, as when my passion clomb to thine;
Shed down thy lucent drench, thy light serene,
Oh, lift me back to Life and Love--oh, shine!
My salt hath lost its virtue in men's blood
And o'er their hearts the marish vapour crawls;
Now Death o'erwhelms me with his colder flood,
And, prey to Time, my royal glory falls.
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THE silvern mistress of the golden Sun,
The milk-white sister to the wine-red Earth,
My lord still smiles upon me, nor will shun
My face for hers of younger, fairer birth.
Though oft her fruitful beauty glides between
And robs me of his countenance, I will
Ne'er hate her, but yield up my borrowed sheen
To make her hallowed nights more hallowed still.
Burn then, my pale and vestal flame, make fair
The nuptials of the amorous Earth with night!
My sickle reaps the lurking stars in air,
My argent shield hangs lucent on the height.
Yet he that chafes and wounds the Earthen shores,
And flees though she embrace--the yearning Sea,--
Is shackled by my smiling and implores
My chaster, colder kiss and mounts to me.
With pearls of white enchantment I bestrew
The happy realms where lovers hunt their bliss;
My ray is pale as frost and soft as dew;
My path is woven in snow through the abyss. 0852c4b9a8
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