Management of Pulmonary Sequestration
Author: Amro Wafi, MD
Institution: University of Cincinnati
Date Reviewed: 2024
Original Case: Jules Lin, MD
Learning Domain: General Thoracic
Learning Objective: Pneumonia, pulmonary sequestration
PowerPoint File: Management of Pulmonary Sequestration
Discussion Points
- Preoperative course of antibiotics if active pneumonia
- Must control the systemic arterial branch in inferior pulmonary ligament
- Resection recommended due to risk of recurrent infection and hemoptysis
- Resection of sequestration alone when possible although lobectomy may be required depending on the size and extent
Learning Points
- 0.2 to 6.4% of congenital pulmonary malformations
- Systemic arterial supply
- No connection to tracheobronchial tree
- Extralobar (own pleural lining) in 25% cases
- Most diagnosed in 1st decade of life
- 3:1 Male to Female ratio
- Related to left diaphragm in 90% and may be subdiaphragmatic
- Drains to systemic right atrium, vena cava, or azygous
- More commonly associated with other anomalies
Learning Points
- Intralobar
- 75% of sequestrations
- Venous drainage typically to pulmonary veins
- 75% with arterial supply from thoracic or abdominal aorta
- Remainder with blood supply from the subclavian, intercostal, celiac, or splenic arteries