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Pulmonary Sequestration

What is a Pulmonary Sequestration?

A pulmonary sequestration is a mass of tissue that develops in the lung but has no respiratory function. Doctors say it does not “communicate” with the systems in the lung. Pulmonary sequestrations are normally found in children—and have even been identified in unborn babies during ultrasounds. Generally, they’re more apt to develop in boys than in girls.

While it is not in itself a life-threatening condition, a pulmonary sequestration can cause health complications including cardiovascular problems, long-term infections like tuberculosis, and bronchial cancer. It could be fatal if blood vessels in the lung begin to hemorrhage.

The Mechanics of a Pulmonary Sequestration

Doctors routinely describe a pulmonary sequestration as an uncommon and usually cystic mass of “primitive” lung tissue. It is not connected to the tracheobronchial tree and serves no purpose inbreathing. Moreover, these growths develop their own blood source. Rather than drawing from the pulmonary blood supply, they get their blood directly from the aorta via an anomalous artery.

There are two types of pulmonary sequestrations:

  • Intrapulmonary sequestrations occur within the existing membrane—visceral pleura—of the lung.
  • Extrapulmonary sequestrations are completely enclosed in their own pleural sac. This version is usually identified early in newborns and even pre-born children. It is likely to develop in conjunction with other malformations, such as heart or gastrointestinal deformities.

Symptoms of a Pulmonary Sequestration

Symptoms for virtually pulmonary sequestrations are similar regardless of their type. But those from an extrapulmonary growth appear during infancy, while those from an intrapulmonary sequestration usually appear after adolescence. They include:

  • Bronchial distress
  • Childhood pneumonia
  • A persistent dry cough

Causes of a Pulmonary Sequestration

The most accepted theory among doctors today regarding the cause or source of pulmonary sequestrations describes initial development from lung tissues in the earliest stages of life. But the precise cause is unknown.

Diagnosing a Pulmonary Sequestration

The diagnostic procedures employed take into account the age of the patient. When diagnosing a pulmonary sequestration, the doctor might conduct any of the following exams:

  • A chest x-ray
  • Ultrasound or Doppler imaging to collect additional details
  • Aortography, a procedure that assesses blood flow

Treating a Pulmonary Sequestration

The most common and recommended treatment is surgical removal of the pulmonary sequestration. Extrapulmonary growths can be removed without the loss of any normal lung tissue. However, intrapulmonary growths tend to be more complicated because they are within the visceral membrane of the lung. Some loss of lung tissue is likely.

In addition to eliminating the sequestration, surgery also diminishes the likelihood that complications related to pulmonary sequestrations will develop. Post-operative results a uniformly very good.