Pulmonary sequestration in older child and in adults
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K Sugio1, S Kaneko, H Yokoyama
1Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Insights
Pulmonary sequestration, a lung abnormality, can occur in adults and may require surgical resection. Early diagnosis and surgical treatment are recommended, even for asymptomatic cases, to prevent potential complications.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Pediatric Surgery
Background:
- Pulmonary sequestration (PS) is a congenital lung malformation.
- While often diagnosed in children with recurrent pneumonia, PS can also present in adults.
- This study reviews surgical cases of PS treated between 1985 and 1990.
Observation:
- Six patients underwent surgical treatment for PS.
- One adult had asymptomatic extralobar sequestration; five younger patients (14-26 years) had intralobar sequestration, with four symptomatic.
- Abnormal chest roentgenograms and anomalous systemic arterial supply were common findings.
Findings:
- Surgical resection was performed for all cases.
- Lower lobectomy was used for intralobar PS, and extirpation for extralobar PS.
- Microscopic infection can occur even in asymptomatic PS lesions.
Implications:
- Surgical resection is a viable treatment for pulmonary sequestration in adults.
- Prompt surgical intervention is advised for PS to prevent future complications.
- This highlights the importance of considering PS in adult patients with respiratory symptoms or abnormal imaging.
Abstract:
Pulmonary sequestration is often found in children with recurrent pneumonia, but is not rare in adults. During the last 6 years (1985-1990), 6 patients with pulmonary sequestration were surgically treated. One 40-year-old patient had an extralobar sequestration, and 5 patients ranging in age from 14 to 26 years had an intralobar sequestration. The patient with extralobar sequestration was asymptomatic. In cases of intralobar sequestration, 4 patients were symptomatic. All 6 patients had an abnormal chest roentgenogram. Preoperative arteriography revealed anomalous blood supply came from a systemic artery in 4 patients. All cases with intralobar sequestration had a lower lobectomy, and one case with extralobar sequestration had an extirpation. Even in cases without any symptoms, there was the possibility of a microscopic infection in the sequestrated lesion with the occurrence of later symptoms. Therefore, patients diagnosed with pulmonary sequestration should be considered for surgical resection.