European Journal of Molecular & Clinical Medicine

Abstract

• CCAM (congenital cystic adenomatoid malformation) is a rare pulmonary developmental hamartomatous defect that involves one or more lobes of the lung and is made up of pulmonary tissue with aberrant bronchial growth. This is a case report of a newborn who underwent surgical excision of CCAM at the age of 20 days. The neonate had CCAM TYPE 1 in the right lower lobe but no cardiac involvement. The surgical procedure called for mild supported manual ventilation until the thorax was opened, then regulated ventilation with judicious fluid management, intra-operative care of hypercarbia and hypoxia, and meticulous post-operative surveillance. With satisfactory respiratory function, surgical excision of the cyst and lobe was successful.
Introduction
• CCAM (congenital cystic adenomatoid malformation) is a lung developmental hamartomatous condition characterised by aberrant bronchial proliferation. Adenomatoid proliferation of bronchioles that forms cysts at the expense of normal alveoli is the most common pathogenic characteristic, which is characterised by hyperinflation and progressive air trapping (1,2) It is frequently unilateral, with varying size and growth, resulting in a variety of clinical presentations ranging from intrauterine foetal death due to hydrops to childhood discovery due to recurrent lung infections. (3). In live births, the incidence ranges from 1 in 70,000 to 1 in 90,000. (4). The successful anaesthetic care of a 20-day-old newborn, as well as the management of intraoperative hypercarbia and hypoxia, are discussed in this case report.