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Extralobar and Intralobar Pulmonary Sequestrations – Report of 4 Cases

Case Report, Volume 05 Issue 1 – January to March 2012

Authors

C P Rauf1, Sangeetha E2, Deepak Kumar R2, Deepti Krishnan2, M Umar Majid2
1Chest Hospital, Pavamani Road, Calicut – 673004
2Indian Medical Association, Anayara PO, Trivandrum


Abstract

It is important to keep in mind Pulmonary sequestration when a patient presents with bronchiectasis or haemoptysis. Sequestration occurs in two forms, the extralobar and the intralobar types. There is a partial or complete separation of part of a lung from the normal connection with the bronchial tree. The arterial blood supply to this region most often arises from the aorta above or below the diaphragm. No pulmonary artery branch is found in the involved segments.

Diagnosis is usually made during investigations for haemoptysis,2 bronchiectasis, or while patient is being taken up for bronchial artery embolisation therapy for massive haemoptysis or during pulmonary resection for bronchiectasis when surgeon finds a systemic arterial supply to the region. The gross appearance is that of nonaerated lung parenchyma resembling liver tissue. Intralobar sequestrations occur about six times as often as extralobar sequestrations. They usually are located in the dorsal segments of the lower lobes. The blood supply comes from the aorta through one or several anomalous arteries, usually originating in the descending aorta or in the aorta below the diaphragm, but it has also been observed arising from intercostals or in nominate artery. Venous drainage is toward the normal pulmonary veins.

We are presenting four cases of Pulmonary Sequestrations. Among four cases two intralobar (one on right side and one on left side). Two extralobar one an right side and one on left side. The clinical and radiological findings are presented.

Keywords: Pulmonary sequestration, Haemoptysis, Bronchiectasis


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