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eComment: Diagnostic and surgical considerations in Swyer–James–MacLeod syndrome

Thoracic Surgery Department, Theagenio Hospital, A. Simeonidi 2, 54007 Thessaloniki, Greece

Swyer–James–MacLeod syndrome; repeated chest drainages in apatient misdiagnosed with pneumothorax

We read with great interest the article by Sulaiman et al. [1] regarding a case of a patient with Swyer–James–McLeod syndrome and we would like to congratulate them and highlight a few points.

Swyer–James–MacLeod syndrome is morphologically characterized by the presence of constrictive bronchiolitis with dilatation and destruction of alveolar structures, resulting in significant air trapping and lung hypoperfusion. The main pathogenetic factor seems to be acute bronchiolitis with obliteration of small airway in childhood [2].

Ventilation perfusion (VQ) scan is very helpful in determining the extent of the disease and correlates well with high resolution computed tomography (HCRT) which seems to be the most valuable technique. The volume and antero-posterior attenuation gradient of the affected lung, size and distribution of central and peripheral pulmonary arteries, air trapping, the patency of main airways and presence of bronchiectasis are investigated. The appearance of the lungs on forced expiration is important in the assessment of Swyer–James–MacLeod syndrome with HCRT and therefore the patient's cooperation is essential. The patient should be placed in the prone position to help identify the typical mosaic pattern of the syndrome.

Surgical treatment is predicated upon the principle that a reduction in lung volume can favorably affect the mechanics of the diaphragm, chest wall and airways. Video-assisted thoracic surgery techniques could be very useful and effective [2].

	References

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1. Sulaiman A, Cavaille A, Vaunois B, Tiffet O. Swyer–James–MacLeod syndrome; repeated chest drainages in a patient misdiagnosed withpneumothorax. Interact CardioVasc Thorac Surg 2009;8:482–484.[Abstract/Free Full Text]
2. Tasaki A, Nakanishi R. Lung volume reduction surgery for a professional athlete with Swyer-James syndrome. Ann Thorac Surg 2005;80:342–344.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Nikolaos Barbetakis Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Barbetakis, N. Articles by Samanidis, G. Search for Related Content PubMed PubMed Citation Articles by Barbetakis, N. Articles by Samanidis, G. Related Collections Related Article