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Case Reports
. 2025 Jan-Dec;18(1):e70019.
doi: 10.1111/ases.70019.

Thoracoscopic Lobectomy for Right Upper Bronchial Atresia Combined With an Azygos Lobe of the Right Lower Lobe in an Infant Patient: A Case Report of a Rare Condition

Nanako Nishida  1 , Keisuke Yano  1 , Yumiko Tabata  1 , Chihiro Kedoin  1 , Ayaka Nagano  1 , Toshio Harumatsu  1 , Yudai Tsuruno  1 , Masakazu Murakami  1 , Koshiro Sugita  1 , Shun Onishi  1 , Koji Yamada  1 , Waka Yamada  1 , Takafumi Kawano  1 , Satoshi Ieiri  1
Affiliations
Case Reports

Thoracoscopic Lobectomy for Right Upper Bronchial Atresia Combined With an Azygos Lobe of the Right Lower Lobe in an Infant Patient: A Case Report of a Rare Condition

Nanako Nishida et al. Asian J Endosc Surg. 2025 Jan-Dec.

Abstract

Bronchial atresia (BA) and azygos lobe (AL) are rare congenital pulmonary abnormalities in pediatric patients. We herein report an infantile case of BA combined with AL that was treated with thoracoscopic surgery. The patient was an 8-month-old boy who was preoperatively diagnosed with BA of the right upper lobe (RUL) combined with an AL using fetal magnetic resonance imaging and postnatal enhanced computed tomography. Thoracoscopic surgery using indocyanine green (ICG)-guided near-infrared fluorescence (NIRF) was performed for BA of the RUL. In the operative findings, the upper lobe bronchus was not recognized, and the pulmonary vessels of the RUL were confirmed using ICG-guided NIRF. The AL was connected to the right lower lobe (RLL). Partial RLL, including AL resection, was performed after RUL resection to prevent postoperative infections and torsion. The postoperative course was uneventful. Thoracoscopic surgery using ICG-guided NIRF was safely performed in an infant with a rare condition.

Keywords: azygos lobe; bronchial atresia; indocyanine green; thoracoscopic surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Preoperative enhanced CT (a) and 3D reconstructed image (b). (a) Enhanced CT revealed a congenital cystic lung lesion in the right upper lobe (yellow arrow) and an azygos lobe (yellow arrowheads). (b) The right upper bronchus was not recognized in the 3D reconstructed image (yellow circle).
FIGURE 2
FIGURE 2
Operative findings. (a) The AL was found to be connected to the right lower lobe (white arrow). (b) AL (yellow arrow) connected to RLL with thin lung parenchyma (white arrowheads).
See this image and copyright information in PMC

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