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Case Reports
. 2017 Apr 23:2017:bcr2016218527.
doi: 10.1136/bcr-2016-218527.

Intradiaphragmatic hybrid lesion: surgical decision-making and value of minimal invasive surgery

Blanca Schuster  1 , Stefan Gerhard Holland-Cunz  1 , Peter Zimmermann  1
Affiliations
Case Reports

Intradiaphragmatic hybrid lesion: surgical decision-making and value of minimal invasive surgery

Blanca Schuster et al. BMJ Case Rep. .

Abstract

Hybrid lesions (HLs) have elements of congenital pulmonary airway malformation and extrapulmonary sequestration (EPS) and belong to the congenital lung lesions. EPS usually arises in the thorax or the abdomen but rarely in the diaphragm. The preoperative diagnostic work-up based on chest radiograph, ultrasound (US) and CT often shows imprecise results. Therefore, the exact localisation of the lesion can only be ascertained intraoperatively. Here we present a patient, with an intradiaphragmatic HL, and demonstrate the difficulties of surgical decision making regarding the localisation of the lesion and discuss the value of minimal invasive surgery.

Keywords: Congenital disorders; Paediatric Surgery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Postnatal plain trunk X-ray with mild diffuse opacity in the left lower zone of the thorax.
Figure 2
Figure 2
Postnatal sonography with typical echogenic structure for a congenital pulmonary airway malformation type II.
Figure 3
Figure 3
CT coronary slides of the contrast study. The lesion and its aberrant vessel coming from the coeliac axis are shown in the left diaphragmatic area.
Figure 4
Figure 4
Intradiaphragmatic hybrid lesion during laparoscopy.
See this image and copyright information in PMC

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