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Despite the huge technical possibilities for perinatal diagnostics, congenital disorders of the respiratory tract including pulmonary anomalies continue to raise difficulties concerning the differential diagnosis.
We present a case of a two-year-old boy who had a history of prolonged dry, non-productive cough, good overall condition, adequate growth and absence of lung and heart auscultatory changes. An X-ray of the lungs and a CT scan with virtual bronchographic image were performed. As a result, congenital lobar emphysema of the left upper lung lobe was diagnosed. It was caused by a slit-like narrowing of the left upper lobar bronchus. The approach with active observation turned out to be the most useful for this patient with asymptomatic emphysema.