Source: Annual Congress 2012 - The good clinical practice: useful case report

Abstract

Background:Pulmonary sequestration (PS) is a rare congenital anomaly.Due to recurrent infections, the treatment in children is surgical removal of the sequestrated lung and this recommendation expands to adulthood.
Objective:To test if asymptomatic or mildly symptomatic adults with PS could be offered conservative follow up instead of surgery.
Methods:We conducted a case series analysis of all patients above 20 yrs old, with sequestration seen in our institute from 2000-2012.Diagnosis, symptoms, patient characteristics, natural course and treatment were reviewed.
Results:During a median follow up of 7.8yrs, no major infection occurred and the lesion size remained unchanged in 4/5 patients while mild infection that resolved with oral antibiotics was noted in 1/5.

Diagnosis, Location, origin of Arterial Vessel, and symptoms

Patient	Diagnosis	Location	Origin of Vessel	Follow up (yrs)	Exacerbations	Life threatening events
1	MDCTA, MRA, Gallium Scan, CT guided Biopsy	LLL	TA	11	0	None
2	MDCTA	RLL	TA	5	0	None
3	MDCTA, PET-CT.	LLL	Abdominal Aorta/Celiac trunk	6	0	None
4	MDCTA, PET- CT.	RLL	TA	11	0	None
5	MDCTA	LLL	TA and Celiac Trunk	6	2	None

CTA =computer tomography angiography, PET=Positron Emission Tomography, LLL=Left lower lobe, RLL=Right lower lobe, TA=Thoracic Aorta

Conclusion:In asymptomatic or mildly symptomatic adult patient with lung sequestration, conservative follow up instead of surgery is a legitimate option.

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Citations should be made in the following way:
A. Dimitriou, Y. Rozenman, I. Ben Dov (Tel Aviv, Israel). Pulmonary sequestration in asymptomatic adults; a plea for conservative observation. Eur Respir J 2012; 40: Suppl. 56, 3502

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