Bronchopulmonary Sequestration ; classification ; pathology ; surgery ; Humans ; Infant ; Lung ; diagnostic imaging ; Male ; Radiography ; Respiratory System Abnormalities ; diagnosis ; surgery

We describe a rare case of extralobar pulmonary sequestration with hemorrhagic infarction in a 10-year-old boy who presented with acute abdominal pain and fever. In our case, internal branching linear architecture, lack of enhancement in the peripheral portion of the lesion with internal hemorrhage, and vascular pedicle were well visualized on preoperative magnetic resonance imaging that led to successful preoperative diagnosis of extralobar pulmonary sequestration with hemorrhagic infarction probably due to torsion.
Abdominal Pain/etiology ; Bronchopulmonary Sequestration/*diagnosis/surgery ; Child ; Fever/etiology ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Pulmonary Infarction/*diagnosis/surgery ; Torsion Abnormality/complications

OBJECTIVETo evaluate the clinical features, diagnosis, treatment, and outcome of intralobar pulmonary sequestration (ILS).

METHODSPatients who were diagnosed with ILS in our hospital between January 1988 and January 2009 were retrospectively reviewed. We recorded the clinical symptoms, imaging findings, operative technique, complications, and outcome of these patients.

RESULTSForty-seven patients (25 men and 22 women) with an average age of 32.3 years were enrolled. Forty-two patients had symptoms including cough and hemoptysis. Chest X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and angiography were performed. Thoracotomy was performed in 45 patients, while thoracoscopy was performed in 2 patients. Lobectomy was the most common treatment procedure. Massive bleeding developed in 2 patients due to injury of aberrant supplying artery intraoperatively, 1 patient had atrial fibrillation, 1 patient had thrombosis of upper extremity postoperatively. All patients were confirmed the diagnosis pathologically, 4 accompanied with bronchogenic cyst, 15 with bronchiectasis, 8 with infection, 2 with aspergilloma, and 1 with carcinoid. No late complications occurred.

CONCLUSIONSILS is rare, surgery is recommended because some patients may have potential severe complications. Contrast enhanced CT and three-dimensional reconstruction is the best diagnostic method. Both thoracotomy and thoracoscopy are appropriate for the selected candidates.

Adolescent ; Adult ; Bronchopulmonary Sequestration ; diagnosis ; diagnostic imaging ; surgery ; Child ; Congenital Abnormalities ; diagnosis ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Treatment Outcome ; Young Adult