Final Diagnosis

Intralobar Pulmonary Sequestration

8/15/2005

History of recurrent pneumonia

Surgical Report

• Intralobar Pulmonary Sequestration, treated with right lower lobectomy

• Two major arteries from the thoracic aorta• Large vein draining sequestered lobe

Bronchopulmonary Sequestration

Definition• Non-functioning lung tissue • Separated from normal bronchial tree• Vascularized by a systemic artery

Two Forms• Intralobar (ILS): within the visceral pleura• Extralobar (ELS): separated from the lung by its

own pleura

Intralobar Pulmonary Sequestration (ILS)

Characteristics• More common type• May present at any age• Generally as recurrent infection• No sexual predominance• Almost exclusively affects lower lobe• Arterial supply: descending aorta• Venous drainage: pulmonary veins

Etiology of Bronchopulmonary

Sequestration

• Accessory bud that forms caudal to lung buds• Traction theory• Postnatal formation

Pulmonary SequestrationComplications

• Recurrent infection• Heart failure• Intralobar malignancy

Treatment of Pulmonary Sequestration

Symptomatic Disease• Surgery: lobectomy or segmental resection• Arterial embolization

Patient Follow-up

• Given granulomas and acid fast bacilli, sputum was sent for culture. Three sputum samples were negative for acid fast bacilli. A ppd was placed and was also negative.

• Patient was treated empirically with IRPE for four months.