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Neonatological and pulmonological management of bilateral pulmonary sequestration in a neonate 
 
Neonatological and pulmonological management of bilateral pulmonary sequestration in a neonate
  Andreas Woerner, Katharina Schwendener, Rainer Wolf, Mathias Nelle
 [Abstract] [Full Text] [PDF]   Pageviews: 9061 Times
 

 Bern, Switzerland

Author Affiliations: Division of Neonatology (Woerner A, Schwendener K, Nelle M) and Division of Pediatric Radiology (Wolf R), Department of Pediatrics, University Children's Hospital, Bern, Switzerland

Corresponding Author: Andreas Woerner, Division of Neonatology, Department of Pediatrics, University Hospital of Berne, Effingerstrasse 102, CH-3010 Bern, Switzerland (Tel: +41 31 632 10 10; Fax: +41 31 632 14 05; Email: andreas.woerner@insel.ch)

Background: Bronchopulmonary sequestration is a lung malformation characterized by nonfunctioning lung tissue without primary communication with the tracheobronchial tree. Intrauterine complications such as mediastinal shift, pleural effusion or fetal hydrothorax can be present. We present the case of a newborn with bilateral intralobar pulmonary sequestration.

Methods: Prenatal ultrasonography in a primigravida at 20 weeks of gestation revealed echogenic masses in the right fetal hemithorax with mediastinal shift towards the left side. Serial ultrasound confirmed persistence of the lesion with otherwise appropriate fetal development. Delivery was uneventful and physical examination revealed an isolated intermittent tachypnea. Chest CT scan and CT angiography showed a bilateral intrathoracic lesion with arterial supply from the aorta.Baby lung function testing suggested possible multiple functional compartments.

Results: Right and left thoracotomy was performed at the age of 7 months. A bilateral intralobar sequestration with vascularisation from the aorta was resected. Pathological and histological examination of the resected tissue confirmed the surgical diagnosis. At the age of 24 months, the child was doing well without pulmonary complications.

Conclusions: Bilateral pulmonary sequestration requires intensive prenatal and postnatal surveillance. Though given the fact of a bilateral pulmonary sequestration, postnatal outcome showed similar favourable characteristics to an unilateral presentation. Baby lung function testing could provide additional information for optimal postnatal management and timing of surgical intervention.

Key words: bilateral; bronchopulmonary sequestration; lung function testing; lung malformation;  neonate; prenatal diagnosis

                   World J Pediatr 2008;4(4):301-304

 

 
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World Journal of Pediatric Surgery

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