C63-52 Intralobar Pulmonary Sequestration Presenting as Recurrent Pneumonia in an Adult Male: A Case Report
Abstract
Pulmonary sequestration (PS) is a rare congenital anomaly involving nonfunctional lung tissue lacking normal bronchial connections and supplied by aberrant extra-pulmonary vasculature. PS typically presenting as recurrent pulmonary infections in adult and typically requires lobectomy.
Case of a 33-year-old male with a history of three months of recurrent pneumonias, presenting due to continued fever and cough, despite multiple courses of antibiotics for suspected community acquired pneumonia. On initial presentation, the patient was afebrile, hemodynamically stable, with no significant laboratory findings or leukocytosis. Plain CT imaging was consistent with left lower lobe pneumonia, 3.5 x 3.1cm adjacent rounded structure concerning for pulmonary abscess, and adjacent nodules favored to represent a mucous impaction in distal airways. Patient was empirically placed on Vancomycin and Cefepime and further investigation with CTA chest was done which revealed left lower lobe intralobar PS. Cardiothoracic surgery was consulted, and the patient was taken for a left-sided muscle-sparing mini-thoracotomy and left lower lobectomy. Intraoperatively, an intraparenchymal sequestration, roughly the size of an orange and filled with micro-pus, was identified. The aberrant blood vessels were ligated, and resection was performed with meticulous bronchial closure and hemostasis.
The patient was managed post-operatively in the ICU as a persistent air leak and non-resolving pneumothorax…
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