A rare case of coexistent intralobar and extralobar pulmonary sequestration

Open Medicine ◽  
2013 ◽  
Vol 8 (1) ◽  
pp. 103-106
Author(s):  
Milos Arsenijevic ◽  
Slobodanka Mitrovic ◽  
Milos Milosavljevic ◽  
Marina Petrovic ◽  
Predrag Djurdjevic ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Left Lung ◽  
Lower Lobe ◽  
Pulmonary Sequestration ◽  
Tracheobronchial Tree ◽  
Functional Disorders ◽  
Intralobar Sequestration ◽  
Post Surgery ◽  
Extralobar Pulmonary Sequestration ◽  
Proper Diagnosis

AbstractIn the pathology of respiratory tract, sequestration presents as a non-functional lung tissue with no communication with tracheobronchial tree. It represents a rare congenital bronchopulmonary and vascular malformation, which occurs at a frequency of 0.1 to 6%. Intralobar and extralobar sequestrations are extremely rare congenital anomalies, especially if they occur at the same time in a patient. Proper diagnosis and appropriate surgical therapy, in the absence of associated anomalies, provide an excellent prognosis. In this paper, we are describing the simultaneous presence of intralobar sequestration (ILS) in the lower lobe of the left lung and extralobar sequestration (ELS) which is positioned on the aortic arch, in a 53 years old man. Two years post surgery, there is no recurrence or any patomorphological and functional disorders in the respiratory tract.

scholarly journals Congenital cystic-adenomatous malformations of the lower lobe of the left lung in combination with intralobar pulmonary sequestration

2021 ◽  
Vol 25 (4) ◽  
pp. 274-277
Author(s):  
A. S. Strashinski ◽  
V. N. Stalmakhovich ◽  
I. N. Kaygorodova ◽  
I. B. Li
Keyword(s):  
Intraoperative Complications ◽  
Correct Diagnosis ◽  
Left Lung ◽  
Lower Lobe ◽  
Pulmonary Sequestration ◽  
Azygos Vein ◽  
Early Postoperative Period ◽  
Diagnostic Tools ◽  
Intravenous Contrast ◽  
Intralobar Sequestration

Introduction. A combination of two rare congenital lung diseases - congenital cystic-adenomatous malformation of the lower lobe of the left lung and intralobar sequestration of the lung- is an extremely rare pathology in medical practice.Material and methods. The article describes a case of successful treatment of an 8-year-old child with cystic-adenomatous transformation of the lower lobe of the left lung in combination with intralobar sequestration. A child with chronic pneumonia was prescribed CT of his chest organs with intravenous contrast enhancement. A combination of cystic adenomatous malformation with intralobar sequestration of the lung was revealed at this examination. The sequestration zone was supplied with blood via the artery from the thoracic aorta, and the wide vein went towards the opposite hemithorax and flowed into the azygos vein. The patient had a planned surgery: left-sided lateral thoracotomy, lower lobectomy with ligation of additional vessels.Results. The early postoperative period was uneventful. Next year, there were no exacerbations of pneumonia. The child considers himself healthy. The histological report No. 31568 - 31577 confirmed type II cystic adenomatous malformation with sequestration of the lung.Conclusion. Modern diagnostic tools allow to put a correct diagnosis at the preoperative stage. In the described case, possible intraoperative complications were avoided because surgeons knew specific blood supply in the diseased area before surgery.

Esophagus-Like Bronchus: A Noncommunicating Bronchopulmonary Foregut Malformation

2021 ◽  
pp. 106689692110022
Author(s):  
Jenny L. Weon ◽  
Stephen Megison ◽  
Charles F. Timmons ◽  
Dinesh Rakheja
Keyword(s):  
Left Lung ◽  
Lower Lobe ◽  
Tracheobronchial Tree ◽  
Pulmonary Infections ◽  
Bronchopulmonary Foregut Malformation ◽  
Radiologic Examination ◽  
Foregut Malformation

We describe a previously unreported bronchopulmonary foregut malformation wherein a segment of a bronchus of the lower lobe of the left lung in a 4-year-old girl was entirely esophageal in structure. No communication was identified between the tracheobronchial tree and the esophagus by radiologic examination or at surgery. The esophagus-like bronchus was associated with an adjacent atretic bronchus and a downstream cavity in the lower lobe of the left lung. The child sought clinical attention because of recurrent pulmonary infections localized to the lower lobe of the lung. We posit that this esophagus-like bronchus is a novel noncommunicating bronchopulmonary foregut malformation.

scholarly journals VATS-resection of the lower lobe of the left lung as a result of treatment of the long-term consequences of postponed foreign body aspiration in the child’s airways: Clinical case

2020 ◽  
pp. 90-95
Author(s):  
M. Opanasenko ◽  
◽  
L. Levanda ◽  
A. Tereshkovich ◽  
I. Liskina ◽  
...  
Keyword(s):  
Foreign Body ◽  
Respiratory Tract ◽  
Clinical Case ◽  
Foreign Bodies ◽  
Correct Diagnosis ◽  
Left Lung ◽  
Lower Lobe ◽  
Physical Exertion ◽  
Recurrent Pneumonia ◽  
The Right

Introduction. Foreign bodies in the airways are a very urgent problem that occurs at any age and quite often requires an urgent and sometimes urgent assessment of the situation, examination, and making the right decision. According to statistics, most often foreign body in airway are found in childhood. In about 95–98% of cases, this pathology is recorded in children aged 1.5 to 3 years. This is due to the behavior of children, their anatomical and physiological characteristics and underdevelopment of protective reflexes. Among all cases of foreign body in airway, foreign bodies of the larynx are found in 12%, trachea – in 18%, bronchus – in 70% of cases. In 80% of cases, CTs enter the right bronchus, as it is a broader and more direct continuation of the trachea. The correct diagnosis is established early after CT aspiration in 40–57% of patients. The mortality rate varies, according to different authors, from 2 to 15%. Clinical case. The boy V., born in 2008. was admitted to the Department of Pediatric Pulmonology on May 30, 2019, with complaints of frequent unproductive cough, mainly daytime, increasing with physical exertion, sometimes subfibril body temperature, weakness, lethargy, decrease appetite. These complaints have been observed for the third time in the last six months. Diagnosis: Foreign body B10 of the left lung. Conclusions. Aspiration of a foreign body into the respiratory tract most often occurs in early childhood (1–3 years). The clinical picture in the early stages is asymptomatic, and over time it leads to the development of inflammatory changes in the lungs, are treated conservatively. Given the complexity of diagnosis, aspiration of a foreign body can lead to frequent recurrent pneumonia, the formation of bronchiectasis in the lower parts of the lungs, which may require surgical treatment. The gold standard of diagnostics is fibrobronchoscopy and spiral computed tomography of the thoracic cavity (SCT OGK), with the help of which, early after aspiration, a foreign body can be detected and subsequently excluded from the respiratory tract. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an participating institution.The informed consent of the child’s parents was obtained from the studies. No conflict of interest was declared by the authors. Key words: child, lungs, foreign body.

scholarly journals Intralobar pulmonary sequestrations in adults

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Lower Lobe ◽  
Pulmonary Sequestration ◽  
Military Hospital ◽  
Lateral Side ◽  
Intralobar Sequestration ◽  
Arterial Blood ◽  
Systemic Artery ◽  
Clinical Presentations ◽  
Chest X Ray ◽  
The Right

Intralobar sequestration accounts for 75% of pulmonary sequestrations. It is characterized by the presence of nonfunctional parenchymal lung tissue, receiving systemic arterial blood supply. We conducted a retrospective medical records review of all patients evaluated and treated in our pulmonary department of military hospital of Tunisia with diagnosis of PS from January 2007 through December 2015. Among them, we report 5 cases of intralobar pulmonary sequestrations operated. There are three women and two men; the mean age is 27.6 years. The sequestration was intralobar in all cases. Clinical presentations were chest pain and productive cough in three cases. Chest X-ray showed left basal opacity in three cases, bilateral basal reticulonodular opacities in one case and round hydric opacity in the right lower lobe in one other case. Computed tomography was performed and revealed an aberrant systemic artery born from the lateral side of aorta supplying a left lower lobe sequestration in four cases and a right lower lobe mass in only one case. The confirmation was operative in all cases and histologic only in three cases. All patients were treated by lobectomy. Only one case presented with a pulmonary sequestration combined with tuberculosis and he was treated firstly by antituberculous chemotherapy. The results were excellent with a favorable clinical course and the mortality was nil.

scholarly journals Orphan Disease in Structure of Recurrent Lower Respiratory Tract Diseases in Children from One To Five

2017 ◽  
Vol 23 (2) ◽  
pp. 66-71
Author(s):  
O. V. Zubarenko ◽  
Larisa Koval ◽  
Katherina Doykova ◽  
Ganna Kopiyka ◽  
V. V. Skrypnyk ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Left Lung ◽  
Lower Lobe ◽  
Orphan Disease ◽  
Atopic Asthma ◽  
Type I ◽  
Respiratory Tract Diseases ◽  
Recurrent Wheezing ◽  
Recurrent Pneumonia

Abstract The paper contains structure analysis of the lower respiratory tract recurrent disease in 180 children aged one to five years, residents of Odessa, who were treated in pulmonology department of Children’s Academician BJ Reznik City Clinical Hospital. The examinees are represented by two groups: 150 children with recurrent wheezing and 30 - with recurrent pneumonia. The selection criteria were: abnormality of central nervous system, abnormality, cystic fibrosis, congenital heart defects, tuberculosis, human immunodeficiency virus-infection. The analysis detected that in the survey sample with recurrent lower respiratory tract disease 3.88% of children had Orphan disease. Thus in the group of children with recurrent wheezing were diagnosed 2 cases of congenital lobar hyperexpansion (ORPHA 1928), one case of lung bronchogenic cyst (ORPHA 2357), one case of pulmonary hypoplasia in the lower lobe of the left lung (ORPHA 2257), and one case of primary ciliary dyskinesia (ORPHA 98,861). Regarding the entire structure of recurrent wheezing, most frequently was detected atopic asthma (49.33%). In 24.6% cases the cause of recurrent wheezing was associated with the otolaryngological pathology. Bronchopulmonary dysplasia was diagnosed in two children. Recurrent pneumonia cases were differentiated if the localization of process was at the same or different places. When one-sided localization of pneumonia was established, next congenital airway malformations were diagnosed - 3 cases of congenital cystic adenomatoid malformations (type I). Genetic pathology often occurred in cases with different lesions location. In all cases of uncertain diagnosis, predictors of recurrent lower respiratory tract diseases were revealed.

Adenocarcinoma in pulmonary sequestration

2011 ◽  
Vol 19 (6) ◽  
pp. 433-435 ◽  
Author(s):  
Lukman Lawal ◽  
Dimitrios Mikroulis ◽  
Savvas Eleftheriadis ◽  
Panagiotis Karros ◽  
Ioannis Bougioukas ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Lower Lobe ◽  
Pulmonary Sequestration ◽  
Fluid Level ◽  
Male Smoker ◽  
Recurrent Pneumonia ◽  
Chest Computed Tomography ◽  
Lower Lobectomy ◽  
Intralobar Sequestration

A 67-year-old male smoker presented with hemoptysis and recurrent pneumonia. Chest computed tomography showed an emphysematous cyst and air-fluid level cavities in the left lower lobe. A left lower lobectomy was performed. The intraoperative finding was intralobar sequestration. Histopathology revealed adenocarcinoma within the sequestrated lobe. Only 8 cases of lung cancer and sequestration have been reported since 1963.

scholarly journals Non-invasive diagnosis in a case of bronchopulmonary sequestration and proposal of diagnostic algorhythm

2016 ◽  
Vol 70 (3) ◽  
Author(s):  
P. Caradonna ◽  
M. Bellia ◽  
F. Cannizzaro ◽  
S. Regio ◽  
M. Midiri ◽  
...  
Keyword(s):  
Lower Lobe ◽  
Maximum Intensity Projection ◽  
Pulmonary Sequestration ◽  
Venous Drainage ◽  
Tracheobronchial Tree ◽  
Arterial Phase ◽  
Non Invasive ◽  
Multiplanar Reconstructions ◽  
Adjacent Structures ◽  
Anomalous Venous Drainage

The case of a 43-year-old woman with intralobar pulmonary sequestration, Pryce type one, is presented. The medical history was characterised by recurrent bronchopneumonia, productive cough with purulent sputum and hemoptysis in the last three years. Diagnosis was made by CT angiography: multiplanar, maximum intensity projection and volume rendering reconstructions were visualised. A volume reduction of middle and lower lobe with multiple cyst-like bronchiectasis was detected and no evident relationship with tracheobronchial tree was pointed out. Reconstructions aimed at evaluating bronchial structures demonstrated no patency of middle and lower lobar bronchi. The study carried out after contrast medium infusion in arterial phase showed a vascular disorder characterised by an accessory arterial branch arising from the upper portion of thoracic aorta which, after moving caudally to pulmonary hilus with a tortuous course, supplied the atelectatic parenchyma. No anomalous venous drainage was detected. The patient underwent surgery with resection of two pulmonary lobes. CT compares favourably with other alternative imaging technique for pulmonary sequestration as multiplanar reconstructions allow not only the detection of supplying vessel, but also the accurate description of heterogeneous characteristics of the mass and adjacent structures. Finally an imaging-based diagnostic algorhythm is proposed.

scholarly journals Surgical treatment of lung sequestration

2008 ◽  
Vol 65 (1) ◽  
pp. 33-39
Author(s):  
Vlado Cvijanovic ◽  
Vojkan Stanic ◽  
Aleksandar Ristanovic ◽  
Bojan Gulic ◽  
Davor Stamenovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Secondary Infection ◽  
Lower Lobe ◽  
Pulmonary Sequestration ◽  
Diagnostic Procedures ◽  
Normal Lung ◽  
Intralobar Sequestration ◽  
Systemic Artery ◽  
Functional Part ◽  
Diagnostic Possibility

Background/Aim. Pulmonary sequestration is a congenital malformation which consists of a functional part of the lung, separated of the normal airway, and vascularisated with anomal systemic artery instead of pulmonary artery. There are two kinds of sequestration. Intralobar is surrounded with normal lung and its pleura, and extralobar which has extrapulmonary position and pleura of its own. This anomaly is very rare and appears in 1.1?1.8% of all congenital lung malformations. The illness is revealed either in early childhood with other life-threatening anomalies or in adulthood and middle age when secondary infection arises. The aim of this paper was to show our own experience in surgical treatment of pulmonary sequestration and to emphasize sequestration as a real differential-diagnostic possibility with patients with recidive bronchopneumonias. Methods. We retrospectively analyzed medical records for the period from 1967?2007 and found 15 patients with pulmonary sequestration at the average age of 30 years. We pointed out the well known problems with identification of this anomaly, preoperative diagnostic procedures and surgical possibilities of treatment. Results. There were 13 patients with intralobar and two patients with extralobar sequestration. By the use of preoperative angiography, seven patients were found to have intralobar pulmonary sequestration. All intralobar sequestrations were clinically manifested, the most often with recidive bronchopneumonia. Six patients had no preoperative diagnosis of lung sequestration. The most common locality of intralobar sequestration was the left lower lobe (eight patients). We performed nine lobectomies, three sequestrectomies, two segmentectomies and one pneumonectomy. Both extralobar sequestrations were diagnosed intraoperatively. Conclusion. Pulmonary sequestration is a rare malformation. Diagnosis is established by angiography. Treatment is exclusively surgical. In the last three years we have had one patient per year. This experience obliges to consider pulmonary sequestration as a real differential- diagnostic possibility in patients with localized repeated bronchopneumonias.

scholarly journals Incidental Finding and Management of Intralobar Sequestration of the Lung in A 24-Year-Old Man

2013 ◽  
Vol 20 (6) ◽  
pp. 403-405 ◽  
Author(s):  
Dhanjit Litt ◽  
Sumeet Gandhi ◽  
Sacha Bhinder ◽  
Maurice Blitz ◽  
Kieran McIntyre
Keyword(s):  
Present Article ◽  
Blood Supply ◽  
Lung Tissue ◽  
Incidental Finding ◽  
Pulmonary Sequestration ◽  
Tracheobronchial Tree ◽  
Arterial Blood Supply ◽  
Intralobar Sequestration ◽  
Arterial Blood ◽  
Pulmonary Arterial

Pulmonary sequestration is described as a dysplastic mass of lung tissue that lacks communication with the tracheobronchial tree and receives systemic rather than pulmonary arterial blood supply. Two distinct classifications, intralobar and extralobar, have been described. The present article discusses the etiology, clinical and radiographic features of pulmonary sequestration as well as the management of this condition when it is discovered incidentally.

scholarly journals Diagnosis of Intra-Abdominal Extralobar Pulmonary Sequestration by means of Ultrasound in a Neonate

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Claudio Rodrigues Pires ◽  
Adriano Czapkowski ◽  
Edward Araujo Júnior ◽  
Sebastião Marques Zanforlin Filho
Keyword(s):  
Abdominal Mass ◽  
Pulmonary Sequestration ◽  
Systemic Circulation ◽  
Vascular Supply ◽  
Tracheobronchial Tree ◽  
Left Adrenal Gland ◽  
Pulmonary Tissue ◽  
Extralobar Pulmonary Sequestration ◽  
Anomalous Artery ◽  
Normal Lungs

Pulmonary sequestration is a congenital abnormality consisting of a mass of pulmonary tissue that presents an abnormal connection with the tracheobronchial tree, with a blood supply coming from an anomalous artery derived from the systemic circulation. Extralobar pulmonary sequestration is characterized by having pleural coverings that are independent of the normal lungs, with vascular supply usually coming from the aorta or from one of its branches. This diagnosis can be suspected prenatally if an abdominal mass, generally below the diaphragm, is seen. Here, we present a case of a neonate on the second day of life, with ultrasonography showing extralobar pulmonary sequestration located above the left adrenal gland that prenatally simulated a neuroblastoma.

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