EXTRALOBAR SEQUESTRATION OF THE LUNG IN CHILDREN

Abstract

Extralobar sequestration of the lung is defined as nonfunctioning lung tissue with no or nonluminous connection with the normal bronchial tree and is covered and surrounded by its own visceral pleura. This definition does not include blood supply from anomalous systemic artery, which will be shown to be absent in many cases. 38 patients with pulmonary sequestration were treated in 1961-84 at our hospital, 22 had intralobar sequestration, 15 extralobar and 1 patient had both types. Only the 16 patients with extralobar sequestrations are further analysed. The age of the patients varied from 21 days to 12 years (mean 3,61 yrs). The sequestration was on the left side in 14 patients and on the right side in three patients. There were only 7 left lower accessory lobes, the lesion was in 7 cases above the lung hilum and in the remaining 2 in the right lower pulmonary region. The most common symptoms were: dyspnea (9), pneumonia (5), cough attack (4), syanosis (3), asthmatic symptoms (2), funnelchest (2), abdominal symptoms (1), routine chest X-ray (1). All 16 patients were operated on and the accessory lobe was removed. Most of the patients were symtomatic and that indicates the necessity of surgical treatment. The clinical picture of extralobar sequestration varies considerably and many of the “typical” features, such as systemic arterial supply, left lower lobe localization and diaphragmatic defect are often absent.

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