Year: 2026 | Month: June | Volume: 13 | Issue: 6 | Pages: 433-438
DOI: https://doi.org/10.52403/ijrr.20260643
Right Lung Agenesis with Dextrocardia in a 4-Month-Old Infant: A Case Report and Literature Review
Yenny Framela, Didik Hariyanto
epartment of Child Health, Faculty of Medicine, Universitas Andalas / Padang/ West Sumatra, Indonesia6.
Corresponding Author: Yenny Framela
ABSTRACT
Background: Pulmonary agenesis is a rare congenital malformation characterised by complete absence of the lung parenchyma, bronchus, and pulmonary vasculature on the affected side. It arises from a disruption of the lung bud during the fourth to fifth week of gestation. Right-sided agenesis is less common than left-sided agenesis but carries a worse prognosis, owing to a greater degree of mediastinal and cardiac shift, distortion of the airway and remaining lung, and a higher risk of recurrent respiratory infection and tracheal compression.
Case presentation: We report a 4-month-old female infant who was referred with fever, cough, and progressive shortness of breath requiring continuous positive airway pressure (CPAP) support. Physical examination revealed asymmetrical chest movement with diminished breath sounds, scanty coarse crackles, and hyperresonance over the right hemithorax, while the cardiac impulse and heart sounds were displaced to the right hemithorax. Laboratory investigations were within normal limits. Chest radiography showed complete opacification of the right hemithorax with mediastinal shift. Computed tomography (CT) confirmed the absence of the right lung parenchyma, the right main bronchus, and the right pulmonary artery, together with compensatory hyperinflation of the left lung. Echocardiography showed dextrocardia with preserved biventricular size and function and no associated structural cardiac defect.
Conclusion: Right lung agenesis with dextrocardia should be considered in any infant presenting with persistent unilateral chest opacification, especially when accompanied by a contralateral mediastinal shift and a displaced cardiac impulse. Cross-sectional imaging is essential for accurate diagnosis and for excluding associated cardiovascular, gastrointestinal, and skeletal anomalies. In the absence of life-threatening associated malformations, management is largely conservative, supported by chest physiotherapy and aggressive treatment of intercurrent respiratory infections, with long-term outcome depending mainly on the functional capacity of the contralateral lung.
Keywords: Dextrocardia; Pulmonary agenesis; Congenital lung anomaly; Infant; Case report