Purpose : Right middle lobe syndrome is characterized by a spectrum of disease from recurrent atelectasis and pneumonitis to bronchiectasis of the Right middle lobe syndrome. It was first reported by Graham describing 12 patients with middle lobe atelectasis and bronchiectasis due to enlarged Iymph nodes. The incidence of Right middle lobe syndrome seems to be increasing in children, but there have been only a few studies of right middle lobe syndrome in Korea.
Methods : Twenty-five children with RMLS who had been admitted during the last 10 years were evaluated with particulars attention to clinical features, laboratory results, bronchographic findings, and treatment.
Results : All patients were symptomatic and complained of chronic cough(25), sputum(20), fever(16), dyspnea(3), vomiting(2), and foreign body in the bronchus(2).
Most of the patients had recurrent pneumonia: 6 patients had Mycoplasma pneumonia, and 6 patients had asthma and allergic disorders. Only 5 out of the 25 patients showed sufficient obstruction on bronchography and 6 patients took computed tomography scans. Chest radiography, bronchography and computed tomography scans were evaluated for review in 25 patients showing consolidation(17), patchy infiltration(14), atelectasis(12), hyperinflation(5) bronchiectasis(2), and air bronchogram(2). Most patients were improved by conservative medical management and only 2 patients had closed thoracostomy.
Conclusion : These 25 patients who had been diagnosed as Right middle lobe syndrome were improved after 2 week’ treatment of antibiotics and conservative
management, and their prognosis were good during the follow-up period.