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Intralobar sequestration. A missed diagnosis.

R A Gustafson1, G F Murray, H E Warden

  • 1Department of Surgery, West Virginia University School of Medicine, Morgantown.

The Annals of Thoracic Surgery
|June 1, 1989
PubMed
Summary
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Intralobar pulmonary sequestration, a cause of recurrent lung infections, was diagnosed in 10 patients. Early arteriography and surgery are recommended for this condition.

Area of Science:

  • Pulmonology
  • Thoracic Surgery
  • Diagnostic Imaging

Background:

  • Intralobar pulmonary sequestration is an uncommon condition.
  • It is often an unrecognized cause of recurrent pulmonary infections, chronic cough, and fevers.
  • Patients frequently experience diagnostic delays and multiple antibiotic treatments.

Purpose of the Study:

  • To review the clinical presentation, diagnostic methods, and treatment outcomes for intralobar pulmonary sequestration.
  • To emphasize the importance of early diagnosis and surgical intervention.

Main Methods:

  • Retrospective review of 10 patients diagnosed with intralobar pulmonary sequestration between 1967 and 1987.
  • Analysis of patient history, diagnostic imaging (chest roentgenogram, bronchography, thoracic arteriography, bronchoscopy), and surgical outcomes.

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Main Results:

  • Nine out of 10 patients presented with recurrent pulmonary infections.
  • Diagnostic delay averaged 1.5 years.
  • Thoracic arteriography effectively visualized the anomalous systemic arterial supply.
  • Surgical intervention (lobectomy or segmentectomy) was performed without morbidity or mortality.

Conclusions:

  • A high index of suspicion for intralobar pulmonary sequestration is crucial in patients with recurrent lower lobe infections.
  • Early diagnostic arteriography followed by surgical intervention can prevent complications and improve outcomes.