Intralobar pulmonary sequestration is a rare congenital lung anomaly. It is defined as a portion of nonfunctioning lung parenchyma that receives its blood supply from an anomalous systemic artery. Patients often present with chronic or recurrent pneumonia. A chest radiograph may show a cystic lesion with air-fluid levels in the lung base. A high index of suspicion is needed for a diagnosis. Surgical removal of a symptomatic intralobar pulmonary sequestration is generally the treatment of choice. Identifying the aberrant artery is a difficult problem when resecting a pulmonary sequestration. The thoracic and abdominal aortas are the most common origins for the abnormal blood supply. However, arterial supply from the celiac artery is quite rare. We present a case of intralobar pulmonary sequestration with the blood supply originating from the celiac artery.
Aorta, Abdominal ; Arteries ; Bronchopulmonary Sequestration ; Celiac Artery ; Humans ; Lung ; Pneumonia ; Respiratory System Abnormalities ; Thorax

Anatomical variations of the inferior mesenteric artery are extremely uncommon, since the inferior mesenteric artery is regularly diverged at the level of the third lumbar vertebra. We found a rare case in which the inferior mesenteric artery arose from the superior mesenteric artery. The findings were made during a routine dissection of the cadaver of an 82-yr-old Korean woman. This is the tenth report on this anomaly, the second female and the first Korean. The superior mesenteric artery normally arising from abdominal aorta sent the inferior mesenteric artery as the second branch. The longitudinal anastomosis vessels between the superior mesenteric artery and inferior mesenteric artery survived to form the common mesenteric artery. This anatomical variation concerning the common mesenteric artery is of clinical importance, performing procedures containing the superior mesenteric artery.
Aged, 80 and over ; Aorta, Abdominal/abnormalities ; Female ; Humans ; Mesenteric Artery, Inferior/*abnormalities/anatomy & histology ; Mesenteric Artery, Superior/*abnormalities/anatomy & histology ; Republic of Korea

OBJECTIVETo investigate the characteristic findings of an anomalous systemic arterial supply to the lung without the pulmonary artery on spiral CT and discuss its nomenclature.

METHODSFour cases of anomalous systemic arterial supply to the left basal segment of the lung without the pulmonary artery were retrospectively reviewed with analysis of the characteristic CT findings.

RESULTSOn spiral CT scans, the involved left lower lung including the entire left basal segments (n=2), the lateral and posterior basal segment (n=1), and the anterior, medial, and posterior basal segment (n=1) had mild volume loss and areas of ground-glass opacity but with normal bronchial trees. The absence of the entire or part of the basal segments of the normal left lower lobar pulmonary artery, anomalous systemic artery originating from the abdominal aorta, diffuse dilatation of the systemic arterial branches distributed in the basal segments of the left lower lobe, and left lower pulmonary venous drainage into left atrium were found in all these patients.

CONCLUSIONThis anomaly presents with characteristic findings on chest spiral CT, for which the nomenclature of local absent pulmonary artery better shows the characteristics of the disease.

Adult ; Aorta, Abdominal ; abnormalities ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Artery ; abnormalities ; diagnostic imaging ; Retrospective Studies ; Terminology as Topic ; Tomography, Spiral Computed

Superior mesenteric artery (SMA) syndrome is a rare condition that results from an extrinsic compression of the third portion of the duodenum, between the SMA and the aorta. The symptoms for the condition consist of abdominal pain and recurrent vomiting, caused by ileus, and can be followed by an electrolyte imbalance and nutrient deficiency. SMA syndrome can follow surgical correction of a spinal deformity, as the aorta migrates forward as the degree of the lumbar lordosis increases, and the retroperitoneal fat tissue decreases, during perioperative abstinence. Any symptoms suggestive of SMA syndrome, after correction of a spinal deformity, should be investigated, as SMA syndrome carries a prolonged hospital stay, with the potential for mortality. An 11 year 10 month old boy, who underwent correction for thoracic kyphoscoliosis, developed postoperative abdominal distension, pain and bilious vomiting. An upper gastrointestinal contrast study revealed SMA syndrome, which required a laparotomy.
Abdominal Pain ; Animals ; Aorta ; Congenital Abnormalities ; Duodenum ; Humans ; Ileus ; Infant ; Intra-Abdominal Fat ; Laparotomy ; Length of Stay ; Lordosis ; Male ; Mesenteric Artery, Superior ; Mortality ; Vomiting

Aorta, Abdominal ; abnormalities ; diagnostic imaging ; pathology ; Aortic Aneurysm, Abdominal ; diagnosis ; diagnostic imaging ; Contrast Media ; Humans ; Tomography, X-Ray Computed ; methods ; Ultrasonography ; methods