Katarao Yu, Indo Takashi, Ueda Satoshi, Yamada Tetsu, Imanishi Naoko, Nagai Shinjiro, Ueda Mitsuhiro, Miyamoto Yoshihiro
Department of Thoracic Surgery, Himeji Medical Center, Himeji, Japan.
Kyobu Geka. 2024 Jul;77(7):554-558.
A 53-year-old asymptomatic woman was admitted to our hospital for evaluation of an area of abnormal intensity in the right lower lobe on cardiovascular magnetic resonance imaging. She denied a history of pneumonia but occasionally expectorated bloody sputum. Contrast-enhanced chest computed tomography (CT) revealed areas of consolidations with multiple cysts within the right lower lobe and an anomalous artery that originated from the descending aorta and entered the right lower lobe. Based on contrast-enhanced CT findings, she was diagnosed with intralobar pulmonary sequestration, and we performed video-assisted thoracoscopic right basal segmentectomy. The anomalous artery was identified in the pulmonary ligament and was ligated using a silk suture at its proximal end, after which the peripheral segment was separated using an automatic suture device. The patient had an uneventful postoperative course, and plain CT at the 6-month postoperative follow-up indicated no evidence of edema of the anomalous artery stump. We recommend early surgical resection even in asymptomatic patients with pulmonary sequestration.
一名53岁无症状女性因心血管磁共振成像显示右下叶有异常强化区域而入院。她否认有肺炎病史,但偶尔咳出带血痰液。增强胸部计算机断层扫描(CT)显示右下叶有实变区域,内有多个囊肿,还有一条异常动脉起源于降主动脉并进入右下叶。根据增强CT表现,她被诊断为叶内型肺隔离症,我们进行了电视辅助胸腔镜右下叶基底段切除术。在肺韧带中识别出异常动脉,并在其近端用丝线结扎,然后使用自动缝合装置分离外周段。患者术后恢复顺利,术后6个月的平扫CT显示异常动脉残端无水肿迹象。我们建议即使是无症状的肺隔离症患者也应尽早进行手术切除。