Extralobar pulmonary sequestration presenting with torsion.

Area of Science:

• Pulmonology
• Pediatric Surgery
• Radiology

Background:

• Extralobar pulmonary sequestration (EPS) is a congenital lung malformation where lung tissue is separated from the normal tracheobronchial tree.
• EPS is typically diagnosed in infancy or childhood, often incidentally found on imaging for other conditions.
• While chest masses are common, symptomatic presentations of EPS are less frequent.

Observation:

• A 13-year-old female presented with acute chest and back pain.
• Initial investigations revealed no signs of infection.
• Imaging studies identified an extralobar pulmonary sequestration as the source of her symptoms.

Findings:

• The patient's symptoms were attributed to torsion and subsequent infarction of the extralobar pulmonary sequestration.
• This represents a rare clinical manifestation of pulmonary sequestration, distinct from typical presentations.
• Torsion leading to infarction is an uncommon complication of this congenital anomaly.

Implications:

• This case underscores the importance of considering rare complications in the differential diagnosis of pediatric chest pain.
• It highlights that extralobar pulmonary sequestration can present acutely due to vascular compromise, not just mass effect or infection.
• Awareness of such presentations can aid in timely diagnosis and management of pediatric pulmonary emergencies.