Related Experiment Videos
[Intralobal sequestration in children--a new concept from the form of bronchial tree in sequestrated lung]
H Ishida1, H Hajikano, A Hayashi
1Department of Surgery, Tokyo Metropolitan Kiyose Children's Hospital, Japan.
Insights
This study differentiates two types of intralobar pulmonary sequestration in children: central and peripheral. The peripheral type, occurring in the lung
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Pulmonary Medicine
Context:
- Intralobar pulmonary sequestration (IPS) is a rare congenital lung malformation.
- Accurate classification of IPS is crucial for diagnosis and treatment planning.
- Previous classifications have not fully distinguished subtypes based on anatomical features.
Purpose:
- To classify intralobar sequestration of the lung in children based on bronchial and vascular anatomy.
- To differentiate between central and peripheral types of IPS.
- To identify distinct histological and anatomical characteristics for each type.
Summary:
- Twenty pediatric cases of intralobar sequestration were analyzed, classifying them into central (8 cases) and peripheral (12 cases) types.
- Central type IPS showed variable lesion sites, with sequestrated bronchi directed centrally and absent normal bronchi; aberrant arteries were muscular, draining to pulmonary veins.
- Peripheral type IPS occurred in the segment 10 area, with sequestrated bronchi directed towards the pulmonary ligament, patent normal bronchi (B10), elastic aberrant arteries, and drainage to pulmonary and/or azygos veins.
Impact:
- This classification provides a clearer understanding of intralobar sequestration subtypes.
- Distinguishing between central and peripheral types may aid in differentiating IPS from other lung diseases.
- The findings can improve diagnostic accuracy and guide surgical management in pediatric patients.
Abstract:
Twenty cases of the intralobal sequestration of the lung in children have been experienced. The age of the patients were from eleven days to fifteen years. Intralobal sequestration was classified into two groups, (central type and peripheral type) by the way of reconstruction of the bronchial tree in the sequestrated lung. In 8 cases of central type, the site of lesion was variable. The bronchial trees of the sequestrated lung were running toward the hilus of the normal lung but the bronchi of the affected area in the normal lung were absent. The aberrant arteries were muscular in histology, and the drainage veins were pulmonary vein. In 12 cases of peripheral type, the lesion was in segment 10 area in every cases. The bronchial trees of the sequestrated lung were running toward the pulmonary ligament where an aberrant artery came from, and B10 of the normal lung were patent. The aberrant arteries were elastic in histology, and the drainage veins were pulmonary and/or azygos vein. It is conceivable that the peripheral type is the real intralobal sequestration and the central type is the mixture of some other diseases.