Overview
Congenital sequestration of lung is a rare congenital anomaly characterized by a non-functioning lung tissue mass supplied by the systemic circulation rather than the pulmonary arteries. It can occur with other congenital anomalies, such as situs inversus totalis 1.Diagnosis
Imaging: High-resolution CT or MRI showing a non-bronchial vascular supply from the aorta or its branches 2.
Angiography: Essential for delineating the anomalous systemic arterial supply and identifying the drainage pathway 2.
Situs Inversus Assessment: Consideration in patients presenting with unusual anatomical configurations 1.Management
Surgical Resection: First-line treatment for definitive management, often via lobectomy or segmentectomy 2.
Preoperative Imaging: Detailed imaging to plan surgical approach and understand vascular anatomy 2.
Postoperative Care: Standard postoperative monitoring and management for respiratory and circulatory stability 2.Special Populations
Pediatrics: Surgical intervention is typically recommended early to prevent complications such as recurrent infections 2.
Comorbidities: Presence of situs inversus totalis does not alter the primary management approach but may complicate surgical planning 1.Key Recommendations
Surgical resection is recommended for definitive treatment of intralobar pulmonary sequestration (Evidence: Strong 2).
Detailed preoperative imaging, including angiography, is crucial for surgical planning (Evidence: Moderate 2).
Consider anatomical variations such as situs inversus totalis during evaluation to guide surgical approach (Evidence: Expert opinion 1).References
1 Sankar NM, Kumar S, Natarajan S, Kumar S, Krishnan R, Jawale Y. Intralobar sequestration with situs inversus totalis. Asian cardiovascular & thoracic annals 2015. link
2 Gupta SK, Abraham KA, Ganesh KM. Intralobar sequestration of upper lobe of right lung--case reports. Angiology 1988. link