Torsed pulmonary sequestration presenting with gastrointestinal manifestations

A unique case of intralobar pulmonary sequestration in an elderly patient: A case report

Pulmonary sequestration (PS) is a rare congenital anomaly characterized by non-functional lung tissue receiving blood supply from an abnormal source. PS is typically diagnosed in young individuals but is uncommon in the elderly. This abstract describes a case of PS in a 62-year-old male patient presenting with recurrent fever, chronic cough, and difficulty breathing. Imaging revealed abnormal lung tissue disconnected from the bronchial tree, with blood supply from the descending thoracic aorta. Surgical intervention successfully treated the condition. The case emphasizes the need to consider PS as a possible diagnosis, even in older patients, and suggests further research into its possible etiologies.

Clinical analysis of extralobar pulmonary sequestration with torsion in children: report of 6 cases

Background

Extralobar pulmonary sequestration is an uncommon congenital pulmonary malformation. Clinically, pedicle torsion of extralobar pulmonary sequestration is extremely rare. Due to inadequate awareness of its atypical presentation and imaging characteristics, clinical diagnosis is very difficult, and it is extremely easy to misdiagnose.

Case presentation

There were 6 children (3 males and 3 females), aged 3–12 years old. The main clinical symptoms of the children were abdominal and chest pain (3 cases), abdominal pain (1 case), chest pain (1 case), and vomiting and abdominal distension (1 case). Two cases were accompanied by fever. Preoperative ultrasound revealed a well-bordered mass with soft-tissue density, accompanied by pleural effusion. On contrast-enhanced computed tomography scans, the mass showed no obvious enhancement. A blood supply was only present in 1 case, and there was no feeding artery shown in the other 5 cases. Extralobar pulmonary sequestration with haemorrhagic infarction was pathologically confirmed. On postoperative days 2–6, the children were discharged uneventfully. There were no complications during the median follow-up of 4 months.

Conclusions

Torsed extralobar pulmonary sequestration usually occurs in childhood or adolescence, with abdominal and/or chest pain as the primary symptoms. Imaging examination shows a well-defined soft-tissue mass without enhancement. The feeding vessel is not clearly displayed in the mass, and extralobar pulmonary sequestration is accompanied by varying amounts of pleural effusion. Video-assisted thoracoscopic surgical resection is associated with excellent prognosis.

A rare case of torsion and infarction of an extralobar pulmonary sequestration with MR, CT, and surgical correlation

Extralobar pulmonary sequestration is a rare congenital pulmonary malformation that may present early in life or remain asymptomatic. Here we present a case of torsion of an extralobar pulmonary sequestration on its vascular pedicle. Although the patient's initial symptomatology suggested intraabdominal pathology, the correct preoperative diagnosis was determined in large part by the lesion's MRI characteristics, which strongly suggested tissue infarction.

Extralobar pulmonary sequestration with a complication of torsion: A case report and literature review

RATIONALE

Pulmonary sequestration is a congenital abnormality of the lower airway. It is characterized by a nonfunctioning mass of lung tissue that lacks normal communication with the tracheobronchial tree or pulmonary arteries and always receives its arterial blood supply from the systemic circulation. Most cases of extralobar pulmonary sequestrations (ELSs) are asymptomatic and found incidentally or in prenatal ultrasound screening.

PATIENT CONCERNS

A 10-year-old boy had severe chest pain and vomiting for 2 days.

DIAGNOSES

ELS was diagnosed, and torsion of the ELS had developed as a complication.

INTERVENTIONS

In video-assisted thoracoscopic surgery, the ELS was resected.

OUTCOMES

The clinical symptoms were relieved the 2nd day after surgery and did not recur over a follow-up period of 3 months.

LESSONS

In young patients with sudden abdominal pain or chest pain, in whom computed tomography shows a well-defined mass of homogeneous soft-tissue density in the thorax, ELS with torsion should be suspected. The presence of a feeding artery greatly supports the diagnosis of ELS, and the absence of this classic finding may indicate torsion of the pulmonary sequestration.

Infarction of torsed extralobar pulmonary sequestration in adolescence

Torsion of pulmonary extralobar sequestration is extremely rare in childhood and adolescence, and as it presents with a variety of symptoms ranging from intermittent pain to fever from infarction, differential diagnosis is necessary. Herein, we report a rare case of 13-year-old girl who presented with abdominal pain and fever was diagnosed as infarction of torsed extralobar pulmonary sequestration. Torsed extralobar pulmonary sequestration was removed by thoracoscopic surgery, and the patient remained in good clinical condition.

Extralobar pulmonary sequestration with hemorrhagic infarction in a child: preoperative imaging diagnosis and pathological correlation

We describe a rare case of extralobar pulmonary sequestration with hemorrhagic infarction in a 10-year-old boy who presented with acute abdominal pain and fever. In our case, internal branching linear architecture, lack of enhancement in the peripheral portion of the lesion with internal hemorrhage, and vascular pedicle were well visualized on preoperative magnetic resonance imaging that led to successful preoperative diagnosis of extralobar pulmonary sequestration with hemorrhagic infarction probably due to torsion.