Extralobar Pulmonary Sequestration Presenting with Torsion and Associated Hydrothorax

Introduction

Pulmonary sequestration has been described as a cystic mass of non-functioning lung parenchyma that lacks a demonstrable connection to the tracheobronchial tree and receives its blood supply anomalously from the systemic circulation [1]. Most bronchopulmonary sequestrations are now identified in utero. Rarely, this lesion is found in the neonatal period. The usual postnatal presentation of a pulmonary sequestration is recurrent pneumonia. Given the lack of communication to the tracheobronchial tree, infectious complications develop most likely from hematogenous seeding. Moreover, an extralobar sequestration is frequently identified as an incidental finding [1] [2] [3].

From January 2000 to May 2009 we treated 22 cases of bronchopulmonary sequestration and none of these cases presented with torsion of the vascular stalk. In the literature only one case of pulmonary sequestration with torsion of the mass has been reported [4].

Herein we report the case of a 11-year-old girl with two left extralobar bronchopulmonary sequestrations, one with torsion, presenting with abdominal pain.

References

• 1 Lima M, Aquino A, Ruggeri G. et al .Lesioni cistiche polmonari congenite. Bologna: CLUEB 2005
• 2 Adzick NS, Farmer DL. Cysts of the lungs and mediastinum. In: Grosfeld JL, O’Neill JA, Fonkalsrud EW, Coran AG. Pediatric Surgery. 6th ed. Philadelphia: Elsevier 2006: 955-970
• 3 Sylvester KG, Albanese CT. Bronchopulmonary malformation. In: Ashcraft KW, Holcomb GW, Murphy JP. Pediatric Surgery. 4th ed. Philadelphia: Elsevier 2005: 276-289
• 4 Huang EY, Manforte HL, Shaul DB. Extralobar pulmonary sequestration presenting with torsion.  Pediatr Surg Int. 2004;  20 218-220
• 5 Ransom JM, Norton JB. Pulmonary sequestration presenting as congestive heart failure.  J Thorac Cardiovasc Surg. 1978;  76 378-381

Correspondence