Extralobar pulmonary sequestration with a complication of torsion: A case report and literature review

Abstract

Rationale: Pulmonary sequestration is a congenital abnormality of the lower airway. It is characterized by a nonfunctioning mass of lung tissue that lacks normal communication with the tracheobronchial tree or pulmonary arteries and always receives its arterial blood supply from the systemic circulation. Most cases of extralobar pulmonary sequestrations (ELSs) are asymptomatic and found incidentally or in prenatal ultrasound screening.

Patient concerns: A 10-year-old boy had severe chest pain and vomiting for 2 days.

Diagnoses: ELS was diagnosed, and torsion of the ELS had developed as a complication.

Interventions: In video-assisted thoracoscopic surgery, the ELS was resected.

Outcomes: The clinical symptoms were relieved the 2nd day after surgery and did not recur over a follow-up period of 3 months.

Lessons: In young patients with sudden abdominal pain or chest pain, in whom computed tomography shows a well-defined mass of homogeneous soft-tissue density in the thorax, ELS with torsion should be suspected. The presence of a feeding artery greatly supports the diagnosis of ELS, and the absence of this classic finding may indicate torsion of the pulmonary sequestration.

Figure 1

Torsion of extralobar pulmonary sequestration in a 10-year-old boy. Contrast medium-enhanced chest computed tomography showed a heterogeneous solid mass with no enhancement in the left lower thorax.

Figure 2

Torsion of extralobar pulmonary sequestration in a 10-year-old boy. A small amount of pleural effusion was identified on the left side.

Figure 3

Torsion of extralobar pulmonary sequestration in a 10-year-old boy. On contrast medium-enhanced chest computed tomography, the suspected feeding artery arising from the aorta is evident (black arrow).