DiChiacchio Laura, Cappiello Clint D, Greenspon Jose
Department of Surgery, Univeristy of Maryland Medical Center, Baltimore, 21201, USA.
Department of Surgery, SSM Health Cardinal Glennon Children's Hospital, St. Louis, 63104, USA.
J Cardiothorac Surg. 2018 Jul 20;13(1):88. doi: 10.1186/s13019-018-0775-9.
Congenital lung malformations exist along a spectrum of pathogenesis and disease severity. Extrapulmonary sequestration (EPS), in which nonfunctional lung tissue develops without connection to the tracheobronchial tree, is one rare manifestation of this disease. Atypical vascular anatomy with a systemic feeding vessel characterizes these lesions.
A 3 day old, 37 week gestation infant underwent chest X-ray for confirmation of umbilical catheter placement and was found to have an elevated left hemidiaphragm consistent with eventration versus congenital diaphragmatic hernia. He remained asymptomatic and was evaluated as an outpatient at the age of 9 months, where CT angiogram demonstrated extrapulmonary versus intrapulmonary sequestration with a systemic feeding vessel from the left internal mammary artery.
It is exceedingly rare for the feeding artery to arise from the internal mammary; two such cases have been reported to date, both in adult patients. Here we present a third case of EPS with arterial supply from the internal mammary successfully treated with video-assisted thoracoscopic resection in a 9 month old infant.
先天性肺畸形在发病机制和疾病严重程度方面存在一系列表现。肺外隔离症（EPS）是该疾病的一种罕见表现，其中无功能的肺组织发育且与气管支气管树无连接。这些病变的特征是具有异常的血管解剖结构，存在一条体循环供血血管。
一名孕37周、出生3天的婴儿因确认脐静脉导管位置而进行胸部X线检查，结果发现左半膈抬高，这与膈膨升或先天性膈疝相符。他一直无症状，在9个月大时作为门诊患者接受评估，此时CT血管造影显示为肺外隔离症与肺内隔离症，有一条来自左乳内动脉的体循环供血血管。
供血动脉起源于乳内动脉极为罕见；迄今为止已报道两例此类病例，均为成年患者。在此，我们报告第三例由乳内动脉供血的肺外隔离症，该9个月大婴儿通过电视辅助胸腔镜切除术成功治疗。
