Pulmonary Sequestration | White Plains Hospital

Pulmonary Sequestration

Pulmonary sequestration or bronchopulmonary sequestration, is a rare congenital abnormality of the lung. Lungs are composed of millions of tiny air sacs referred to as alveoli. These alveoli communicate with your airways and allow for the transportation of oxygen into your bloodstream and the removal of carbon dioxide from your bloodstream. Each lung is broken into portions referred to as lobes with the right lung usually consisting of three lobes and the left lung usually having two lobes. Each lobe is further divided into segments. The assignment of areas of the lungs into lobes and segments is based on each area having its own group of alveoli, airway, and arterial and venous blood supply.

In pulmonary sequestration, an abnormal, nonfunctioning mass of lung tissue is present. It lacks normal communication with the airway, referred to as the tracheobronchial tree. Unlike normal lung tissue that receives its arterial blood supply from the right side of the heart, pulmonary sequestration's received their blood supply from blood vessels after they have exited the left side of the heart, referred to as the systemic circulation.

Symptoms

  • Symptoms vary depending on type of sequestration and age of symptom development
  • Persistent cough
  • Coughing up blood
  • Episodes of pneumonia

Types of Pulmonary Sequestrations

Intralobar Sequestration

  • Within pleura lining of a pulmonary lobe
  • Drains into pulmonary veins
  • Usually cystic, frequently infected
  • Most common form accounting for 75% of all sequestrations
  • Presents in adulthood
  • Male/Female predominance equal
  • 2/3 of time seen in lower portion of left chest
  • Rarely associated with other developmental abnormalities
  • Blood supply may come from abdomen or chest

Extralobar Sequestration

  • Outside of normal pulmonary lobe with its own lining
  • Drains outside of normal lung venous drainage
  • Isolated from lung, rarely infected
  • Less common, 25% of all sequestrations
  • Usually presents in infancy
  • Male 80%/Female 20%
  • 90% seen in left chest
  • Commonly associated with congenital abnormalities such as diaphragmatic hernias, congenital heart disease, bowel abnormalities, and spinal abnormalities
  • Blood supply usually within abdomen

Diagnostic Tests

  • Frequently suggested on chest x-ray
  • Best seen on CT Scan or MRI
  • Evaluation of blood supply important in determining approach

Treatment

  • Surgical removal
  • Usually removed through Minimally Invasive Thoroscopic Surgery
  • May require pretreatment of abnormal blood supply
  • Surgery safe with very low complication rate

Here at White Plains Hospital, the experienced team of thoracic surgeons will assess patients to determine if a minimally invasive thoroscopic procedure can be safely performed. The experience and expertise of the thoracic surgical team with allow customization of the procedure for each individual patient to afford them the best solution to their individual situation.