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Neonatological and pulmonological management of bilateral pulmonary sequestration in a neonate

Woerner, Andreas ; Schwendener, Katharina ; Wolf, Rainer ; Nelle, Mathias

In: World Journal of Pediatrics, 2008, vol. 4, no. 4, p. 301-304

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    Titre
    • Neonatological and pulmonological management of bilateral pulmonary sequestration in a neonate
    Auteur
    • Woerner, Andreas. Division of Neonatology, Department of Pediatrics, University Children's Hospital, Bern, Switzerland
    • Schwendener, Katharina. Division of Neonatology, Department of Pediatrics, University Children's Hospital, Bern, Switzerland
    • Wolf, Rainer. Division of Pediatric Radiology, Department of Pediatrics, University Children's Hospital, Bern, Switzerland
    • Nelle, Mathias. Division of Neonatology, Department of Pediatrics, University Children's Hospital, Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • World Journal of Pediatrics, 2008, vol. 4, no. 4, p. 301-304. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:320226
    Summary
    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