RT Journal Article SR Electronic T1 Iatrogenic pneumothorax in a 4-week-old girl: new diagnosis of congenital lobar emphysema JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e233302 DO 10.1136/bcr-2019-233302 VO 13 IS 2 A1 Ashley Reed A1 Sandra Fernandes Lucas A1 Agnieszka Nowacka A1 Chukwubuike Eze YR 2020 UL http://casereports.bmj.com/content/13/2/e233302.abstract AB A 4-week-old female patient presented with severe respiratory distress, hypoxia and apnoeic episodes on a background of a few-day history of coryza and cough. There was significantly reduced air entry on the left side and a displacement of the apex beat to the right of the chest. The examination findings with oxygen desaturations and a right-sided mediastinal shift on chest X-ray led to a diagnosis of tension pneumothorax following which a needle thoracentesis was undertaken. This appeared to worsen the patient’s clinical condition; hence, a chest drain was inserted with unsatisfactory clinical improvement. In view of the presentation and lack of clinical improvement after chest drain insertion, the case was transferred to the paediatric respiratory team in a tertiary centre where the diagnosis was revised to congenital lobar emphysema based on chest computer tomography findings. She subsequently benefited from a left upper lobectomy and lingulectomy and was discharged home 4 days after surgery.