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Intralobar Pulmonary Sequestration – Clinical Case In A Three-Year-Old Child

P. Shivachev, K. Ganeva, M. Boyadzhiev, M. Avdzhiyska

Abstract

Pulmonary sequestration is a rare congenital lung anomaly, which presents with a solid or cystic primitive tissue that has no function. Commonly, this formation does not communicate with the tracheobronchial tree and has an anomalous blood supply, most often from the systemic circulation. There are two types of pulmonary sequestration – intralobar (intrapulmonary) and extralobar (extrapulmonary).

We present a 3-year-old boy from normal pregnancy and delivery through Cesarean section with intralobar pulmonary sequestration. The child is with normal physical and neuropsychological development, has had all the necessary vaccinations, and suffers from frequent respiratory infections with recurrent cough. The anomaly was discovered accidentally during another hospitalization due to cough, but without a fever, and with suspected inflammatory changes in the radiography, with a wider mediastinal shadow. The performed chest CT with contrast revealed a cystic formation in the posterior-basal left lung with an anomalous supply from the thoracic aorta. Despite the controversial behavior in sequestration, without or with mild symptoms, the child was referred for consultation with a pediatric surgeon and for possible surgical treatment.

Pulmonary sequestration is a rare congenital anomaly with the intralobar type being more frequent. A distinctive feature for the latter is the absence of clinical symptoms, especially in childhood. However, it has to be suspected in cases of a chronic cough and recurrent pneumonias. Non-invasive imaging techniques, such as CT angiography, MRI, echography, including fetal one, are the preferred diagnostic tool.

Keywords

pulmonary sequestration, congenital pulmonary anomaly, childhood

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References

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