An actual concept of pulmonary sequestration

Annotation. Pulmonary sequestration is one of the most common malformations of this organ in clinical practice. But there may be difficulties in interpreting of radiology studies, which leads to a violation of the methodology of the study in such patients, and consequently – the lack of success of the therapy and the correct routing.

Purpose of the study. To present a literature review of current data related to lung sequestration, to discuss important clinical aspects of this abnormality and features of tactics. The review also describes the radiology patterns of sequestration with an emphasis on CT signs; typical images and methodological specificity of scanning in these patients are present and based on own practice experience.

Materials and methods. Both “classical” and modern local and foreign scientific papers about lung sequestration in adults and children are considered with a description of the morphology of the lesion, the clinical symptoms and the actual CXR and CT imaging; modern features of surgical treatment of such patients are presented.

Results. Often, lung sequestration manifests itself already in adulthood, without creating the impression of a congenital anomaly, hiding under the “masks” of abscessing pneumonia, neoplasm. The clinical course of lung sequestration is not specific and is characteristic of many respiratory complaints, but at the same time – the anomaly requires a different management tactics than ordinary inflammatory processes and is associated with the need to consult a thoracic surgeon. Due to the limited differentiation of the sequestration structure in CXR, in current time, if sequestration is suspected, CT with angiography is indicated. An aberrant vessel can trace not only from the thoracic, but also from the abdominal aorta, its branches.

Conclusion. The correct interpretation of the revealed CT-signs allowed routing patients to a hospital with thoracic surgery department because in the majority of cases, to prevent repeated episodes of sequestr inflammation, it is necessary to remove it. The expansion of the scanning area below the diaphragm can be useful because some of the sequesters are supplied with blood from the abdominal aorta and its visceral branches – this will prevent repeated CT-angiography studies because information about the source of blood supply is extremely important for surgeons.

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