Unilateral lung hypoplasia or agenesis can be asymptomatic or present with
recurrent respiratory symptoms. The latter may be amenable to surgical trea
tment in selected cases. Of four children in this report, two are being man
aged without surgery. A third was relieved of his symptoms by pneumonectomy
. The fourth presented with acute foreign-body inhalation into the healthy
right main bronchus, and coexistent left pulmonary agenesis was discovered
at bronchoscopy. Bronchoscopy and computed tomography were found to be the
most useful investigations in management.