Thoracoscopic treatment of a rare bilateral extralobar lung sequestration in a 3-years old girl (original) (raw)
Related papers
Thoracoscopic Excision of Prenatal Diagnosed Extralobar Pulmonary Sequestration – Case Report
Jurnalul Pediatrului, 2020
Background: Pulmonary sequestrations are rare congenital bronchopulmonary malformation. Two types of bronchopulmonary sequestration have been described: intralobar and, extralobar sequestration. Case report: We present the case of a male patient with extralobar sequestration diagnosed prenatally and successfully treated by means of video-assisted surgical excision at the age of 7 months. Prenatal diagnostic of pulmonary malformation was suspected at routine ultrasound and confirmed on fetal MRI. The baby was delivered at 39 weeks of gestation by C-section. The diagnostic of extralobar sequestration was confirmed by CT scan performed at the age of 1 month. The child was asymptomatic so the surgical excision of the mass was performed after the age of 6 months by means of video-assisted thoracoscopy. The procedure was technical challenging but underwent flawless. The postoperative course was uneventful. Conclusions: Prenatal diagnostics is a very useful tool in planning and making appropriate therapeutic decision for patients with pulmonary sequestration. Video-assisted thoracoscopic excision is the optimal treatment option for extralobar sequestration.
Congenital lung abnormality in a 1-yr old
European Respiratory Journal, 2004
An asymptomatic 8-week-old male infant was referred for assessment. A prenatal ultrasound had been suggestive of a congenital cystic adenomatoid malformation (CCAM). Following delivery, he had a plain chest radiograph ( ) and went on to have a computed tomography (CT) scan of the thorax ( ), which showed an extrapulmonary mass close to the vertebral column. He proceeded to have magnetic resonance imaging of the thorax to look for intraspinal extension. The appearances were not anticipated, in that the lesion appeared to be intrapulmonary with no extension into the mediastinum, spinal canal or chest wall. The diaphragm was reported as being intact and separating the lesion from the abdominal cavity. There were no abnormal vessels reported. These features were in keeping with an intrapulmonary cystic lesion and the infant was referred for a surgical opinion. As the infant remained well, surgery was deferred until the child was 1-yr old.
The management of asymptomatic congenital lung malformations
Paediatric Respiratory Reviews, 2004
Congenital Pulmonary Airway Malformation (CPAM) and lung sequestration are often discovered on routine prenatal sonography. While some lesions may be large and cause serious complications in the fetus or newborn, many will be asymptomatic at birth. Some authors advocate simple observation because of the lack of data on the incidence of long-term complications. However, there are very few described cases where CPAM and intralobar sequestration (ILS) have remained asymptomatic throughout life; complications eventually develop in virtually all patients. The most common complication is pneumonia, which may respond poorly to medical treatment. Other complications include the development of malignancies (carcinomas and pleuropulmonary blastomas), pneumothorax and hemoptysis or hemothorax.
Successful surgical management of intralobar pulmonary sequestration in Ghana
Journal of surgical case reports, 2022
Pulmonary sequestration occurs when a portion of lung tissue receives its blood supply from an anomalous systemic artery. Three main presentations, intralobar, extralobar and communicating bronchopulmonary foregut malformations, have been described. It is the second most common congenital lung anomaly. The intralobar variant is the most common type seen in 75% of cases, especially in late childhood. Imaging of choice for diagnosis are computed tomography scan and magnetic resonance imaging. Management involves surgical resection with ligation of the aberrant blood supply via thoracotomy or thoracoscopy. Endovascular therapy with coil embolization of the aberrant anomalous systemic artery as a standard therapy or as a hybrid therapy is an option. We present our successful surgical management of an infant diagnosed prenatally with congenital lung abnormality and confirmed postnatally as intralobar pulmonary sequestration.
Pediatric and Developmental Pathology, 2003
The origin of intralobar sequestration of the lung (ILS)—whether congenital or acquired—has often been controversial, since firm anatomical evidence of prenatal origin has been sparse. We describe four cases in which anomalous arterial supply from the aorta to abnormally echogenic lower lung lobes was demonstrated on routine antenatal ultrasound examination, and the diagnosis of ILS was subsequently confirmed by postmortem examination including bronchography of the fetuses at between 20 and 23 wk. One right-sided lesion was supplied from a branch of the coeliac axis, and three left-sided lesions were supplied from the thoracic aorta. In two cases, the arterial supply was shown to be multiple. All lesions were situated in the lower lobes. They showed a cystic transformation of the affected lung tissue which was histologically indistinguishable from cases diagnosed as congenital cystic adenomatoid lesion (CCAM) at the same gestational age, but clearly different from that seen in bronchial obstruction due to laryngeal stenosis at that age. Similar vascular lesions have been reported in otherwise normal lungs. The character of the anomalous arterial vessels is consistent with origin from the embryonic splanchnic plexus. The precise sequence of pathogenetic events is unclear but there appears to be a close relationship of this condition not only with CCAM but also with the condition of anomalous arterial supply to the lower lobe.
Uniportal thoracoscopic resection of intralobar and extralobar pulmonary sequestration
Journal of visualized surgery, 2018
Pulmonary sequestration (PS) is a rare congenital malformation of the respiratory tract. Two main variants are described, the intralobar and the extralobar PS. Clinical manifestations vary from accidental findings to life threatening complications. Surgical resection is the definitive and indicated treatment of PS. The operation could be performed through an open thoracotomy or video-assisted thoracic surgery approach. We report the management of two patients with diagnosis of extralobar PS in the first case and intralobar PS in the second case. Both patients underwent uniportal video-assisted thoracic surgery resection of PS with success. In our experience, we confirm that uniportal video-assisted thoracic surgery is a safe and feasible approach for extralobar and intralobar PS.
Journal of Cardiothoracic Surgery
Background: Congenital lung malformations exist along a spectrum of pathogenesis and disease severity. Extrapulmonary sequestration (EPS), in which nonfunctional lung tissue develops without connection to the tracheobronchial tree, is one rare manifestation of this disease. Atypical vascular anatomy with a systemic feeding vessel characterizes these lesions. Case presentation: A 3 day old, 37 week gestation infant underwent chest X-ray for confirmation of umbilical catheter placement and was found to have an elevated left hemidiaphragm consistent with eventration versus congenital diaphragmatic hernia. He remained asymptomatic and was evaluated as an outpatient at the age of 9 months, where CT angiogram demonstrated extrapulmonary versus intrapulmonary sequestration with a systemic feeding vessel from the left internal mammary artery. Conclusions: It is exceedingly rare for the feeding artery to arise from the internal mammary; two such cases have been reported to date, both in adult patients. Here we present a third case of EPS with arterial supply from the internal mammary successfully treated with video-assisted thoracoscopic resection in a 9 month old infant.
Congenital Lung Malformations, Update and Treatment
2009
SUMMARY There is a broad spectrum of bronchopulmonary malformations which present in early infancy and childhood. These include Bronchogenic cysts, Bronchopulmonary sequestrations, congenital cystic adenomatoid malformation (CCAM), and congenital lobar emphysema. These lesions maybe detected by prenatal diagnosis, present as acute respiratory distress in the newborn period, or may remain undiagnosed and asymptomatic until late in life. Pulmonary sequestration (PS) is a rare congenital malformation of the lower respiratory tract. It consists of a non-functioning mass of lung tissue that lacks normal communication with the tracheobronchial tree and receives its’ arterial blood supply from the systemic circulation. CCAMs are extremely rare with the reported incidence being between 1/25,000 and 1/35,000 . The pathogenesis is uncertain but appears to result from a abnormality of the branching morphogenesis of the lung and represents a maturation defect. Congenital Lobar Emphysema (CLE) i...