Vol. 59, No. 9, September 2009 641 Case Report Foreign body or Foreign from body — Congenital Unilateral Lobar Hypoplasia of Lung Heeramani Lohana, Syed Rehan Ali, Shakeel Ahmed Department of Paediatrics and Child Health, Aga Khan University Hospital, Karachi, Pakistan. Abstract We report a rare case of congenital unilateral hypoplasia of the lung without any other anomaly at Aga Khan University Hospital. A 7-month-old male infant presented in emergency room with respiratory distress. There was no history of cough and wheeze. X-ray revealed left sided non homogenous opacity along with right sided hyperinflation. A suspicion of foreign body was made on chest X-ray but bronchoscopy was deferred in view of bilateral equal air entry and absence of wheeze. CT scan showed left upper lobe hypoplasia. Child recovered with supportive therapy and was discharged home. To the best of our knowledge unilateral lobar malformation of the lung is an extremely rare entity and few cases have been reported so far. Introduction Unilateral absence of a lung /a lobe (hypoplasia) is one of the rare congenital abnormalities. 1 Such lesions may present with respiratory symptoms at birth or may be detected incidentally. It is generally asymptomatic, or may be symptomatic with recurrent episodes of wheezing and/or pneumonia. Diagnosis is usually made by X-ray and C-T scan. 2 Asymptomatic cases generally do not require any treatment. Recurrent chest infections should be treated aggressively in patients with absence of a congenital lobe. Case Report A seven month old male infant presented with complaints of low grade fever and mild respiratory distress. There was a history of a similar episode 3 months back when he was admitted in another hospital where X-ray chest showed non homogenous opacity involving the whole of left hemi thorax. He was treated as pneumonia with intravenous antibiotics and was discharged home after 3 days. He remained perfectly well thereafter. The perinatal and developmental history was normal. No parental consanguinity was present. The infant had a normal weight and length for age and was well nourished. There was no obvious congenital abnormality. Chest examination showed mild tachypnea with bilateral equal air entry, absence of wheeze and normal vesicular breathing. Rest of the examination was unremarkable. His X-ray chest (Figure-1) showed complete non homogenous opacity of left hemi thorax with compensatory hyperinflation of right lung, shifting