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[Bronchopulmonary sequestration and pseudosequestration].

R S Lai1, M L Kuo, M S Chern

  • 1Department of Chest Medicine, Veterans General Hospital, Taipei.

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|March 1, 1991
PubMed
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Bronchopulmonary sequestration is a rare congenital lung anomaly with abnormal systemic artery supply. Distinguishing it from pseudosequestration presents diagnostic challenges, with potential complications like infection and bleeding.

Area of Science:

  • Medical Imaging
  • Thoracic Surgery
  • Pediatric Pulmonology

Background:

  • Bronchopulmonary sequestration (BPS) is a rare congenital lung malformation involving aberrant systemic arterial supply.
  • Pseudosequestration shares systemic arterial supply but maintains normal bronchial connections, often with superimposed infection.
  • Chronic inflammation in the lung may trigger neovascularization from systemic circulation.

Purpose of the Study:

  • To report on a series of bronchopulmonary sequestration and pseudosequestration cases.
  • To analyze the clinical and radiological characteristics of these conditions.
  • To highlight diagnostic challenges and potential complications.

Main Methods:

  • Retrospective review of 15 bronchopulmonary sequestration cases and 1 pseudosequestration case.

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  • Analysis of patient demographics, radiological findings, and arterial supply.
  • Evaluation of preoperative diagnostic accuracy and intraoperative complications.

    • Main Results:

    • The study included mostly young adults (mean age 24.6 years).
    • Intralobar sequestration constituted 86.6% of cases, with aberrant arteries typically originating from the thoracic aorta (84.6%).
    • Radiological findings often presented as mass lesions or cysts with air-fluid levels (80%), complicating differentiation between sequestration and pseudosequestration.

    Conclusions:

    • Bronchopulmonary sequestration and pseudosequestration share similar radiological features, posing diagnostic difficulties.
    • Accurate preoperative diagnosis was achieved in less than half of the cases.
    • Significant complications, including recurrent infections and intraoperative bleeding, underscore the importance of timely diagnosis and management.