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AimTo provide a further insight into the usefulness of lung biopsy in children.MethodsLung biopsies in children from January 2007 to December 2017 were reviewed (n=39). The histology results were categorised as: definitive diagnosis, normal lung parenchyma, inconclusive.ResultsLung biopsy provided a definitive diagnosis in 25 (64%) cases. A suspected diagnosis was confirmed in 16 (41%) and a new diagnosis was found in 9 (23%) children. Histology was inconclusive in 11 (28%) cases and normal in 3 (8%). Fifteen (38%) children had treatment altered due to the biopsy result.ConclusionLung biopsy mostly confirmed the suspected diagnosis and was associated with a low procedure related morbidity (n=1) and mortality (n=0). Importantly, the biopsy result identified a pathology which altered treatment in over one third of patients. However, in a number of cases the histology was inconclusive, therefore careful patient selection is recommended to maximise diagnostic yield.

Right thoracotomy for oesophageal atresia (OA) with dextrocardia is technically challenging due to the heart being in the operative field, and also due to the possibility of right-sided aortic arch. We report a neonate with long-gap OA with tracheo-oesophageal fistula (TOF), dextrocardia, and left-sided aortic arch who was successfully operated by using right thoracotomy. On the basis of our review of the literature and our experience from this case, we found that conventional right thoracotomy is appropriate for OA+ TOF associated with dextrocardia and left aortic arch, and left thoracotomy in dextrocardia and right aortic arch.