Pulmonary sequestration
Overview
A pulmonary sequestration, also known as a bronchopulmonary sequestration or a cystic lung lesion, is a medical condition where a piece of tissue that develops into lung tissue is not attached to the pulmonary blood supply and does not communicate with the other lung tissue. Often it gets its blood supply from the thoracic aorta. Communication is a medical phrase indicating that it is not connected to the standard bronchial airways and that it performs no function in respiration.
Symptoms
Symptoms can vary greatly, but they include a persistent dry cough.
Diagnosis
Sequestrations can be identified in-utero via an abnormal artery on ultrasound. The gold standard for diagnosis is pulmonary angiography. But since it is a very invasive procedure, it is getting replaced by CT Scan with a contrasting fluid, as the investigation of choice. Further studies are required for comparing sensitivity and specificity of angiograms versus ct scans in diagnosing pulmonary sequestration.
Treatment
Usually the sequestration is removed after birth via surgery. In most cases this surgery is safe and effective; the child will grow up to have normal lung function. In a few instances, fetuses with sequestrations develop problematic fluid collections in the chest cavity. In these situations a Harrison catheter shunt can be used to drain the chest fluid into the amniotic fluid. In rare instances where the fetus has a very large lesion, resuscitation after delivery can be dangerous. In these situations a specialized delivery for management of the airway compression can be planned called the EXIT procedure.