Radiological features are in favor of congenital left pulmonary agenesis. If unilateral, the remaining lung contains a double amount of alveoli but normal bronchi. Pulmonary agenesis and aplasia are difficult to discriminate, agenesis differs from aplasia by the presence of a rudimentary bronchus in the latter. They differ from pulmonary hypoplasia which has immature pulmonary tissues. Patients are usually asymptomatic and diagnosis is usually incidental at childhood, however they have increased susceptibility to infection ¹.