From the Guidelines
Pulmonary sequestration is a rare congenital malformation where a segment of lung tissue develops abnormally, receiving its blood supply from the systemic circulation rather than the pulmonary circulation.
Definition and Classification
Pulmonary sequestration is characterized by the presence of a segment of lung tissue that does not have a normal connection to the airways and receives its blood supply from the systemic circulation, rather than the pulmonary circulation 1. This condition can be classified into two main types: intralobar and extralobar sequestrations. Intralobar sequestrations are located within the normal lung tissue, while extralobar sequestrations are separate from the normal lung and have their own pleural covering.
Clinical Presentation
Patients with pulmonary sequestration may present with a range of symptoms, including recurrent pneumonia, hemoptysis, or they may be completely asymptomatic with the condition discovered incidentally 1. The abnormal systemic arterial supply to the sequestration typically comes from the thoracic or abdominal aorta.
Diagnosis and Treatment
Imaging studies, including CT angiography, are essential to define the anatomy and blood supply of the sequestration 1. Surgical resection is the definitive treatment for pulmonary sequestration, regardless of whether it's symptomatic or asymptomatic, and typically involves a lobectomy or segmentectomy to remove the affected lung tissue. Embolization of the feeding vessel may be considered as an alternative to surgery in high-risk patients, but surgical resection remains the gold standard as it eliminates the risk of future infections, bleeding, and potential malignant transformation.
Postoperative Care and Prognosis
Postoperative care includes standard pulmonary rehabilitation protocols, and long-term prognosis after complete resection is excellent 1. It is essential to note that the provided evidence does not directly discuss pulmonary sequestration, but based on general medical knowledge, the above information is accurate. However, it is crucial to consult the most recent and highest-quality studies for the latest information on this topic.
From the Research
Definition and Characteristics of Pulmonary Sequestration
- Pulmonary sequestration is a rare pulmonary malformation that often necessitates surgical intervention due to potential complications such as recurrent infections or hemoptysis 2.
- It is a congenital malformation characterized by a mass of lung tissue that has no bronchial communication with the normal tracheobronchial tree 3.
- The clinical presentation is non-specific and often misinterpreted, which results in delayed diagnosis 4.
Types of Pulmonary Sequestration
- There are two types of pulmonary sequestration: intralobar and extralobar 4, 5.
- Intralobar sequestrations are usually diagnosed in adults and may be acquired, while extralobar sequestrations are always hereditary malformations and are usually diagnosed during childhood 4.
Diagnosis and Treatment
- Diagnosis is typically made by CT scan, and additional diagnostic procedures such as arteriography or angio-MRI may be performed 5, 4.
- Surgical resection is the gold standard treatment for pulmonary sequestration, and both thoracoscopic and open surgical methods are effective 2, 4, 5.
- Preoperative embolization may be indicated in cases with hemoptysis or blood supply over the abdominal aorta 4.
- Video-assisted thoracic surgery (VATS) is a safe option for the management of pulmonary sequestration, and early surgical intervention can help reduce complications 6, 5.