• Journal of Chest Surgery
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• v.18 no.2
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• pp.320-326
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• 1985

Pulmonary sequestration occurs when some disturbance produces a cystic mass of nonfunctioning lung tissue which lacks normal communication with the tracheobronchial tree. Between 1971 and 1985, pulmonary sequestration was diagnosed in 11 patients, ranging age from 3 to 29 years. All sequestration were intralobar type. Definitive diagnosis can only be obtained by aortography and/or surgical exploration in 10 cases. The other one was confirmed by pathologic examination postoperatively. The presenting complaints were mostly recurrent local pulmonary infection, but in 2 cases mediastinal mass with respiratory symptoms was presented, and cardiac murmur was only finding in one case. Preoperative diagnostic procedure revealed 3 associated anomalies which were funnel chest, right aortic arch, and pulmonic stenosis with vascular ring. Operative treatment for sequestration was lobectomy in 10 cases, and a segmentectomy in one. There was no operative mortality, but 3 complications [empyema, B-P fistula, post-op bleeding] which were controlled by subsequent operations or conservative measure. Aortography is strongly advocated not only for its diagnostic value, but for its preoperative localization of the aberrant vessels that are the major concern to the surgeon.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.357-361
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• 1990

The pulmonary sequestration is rare congenital pulmonary disease with nonfunctioning lung tissue supplied by aberrant arteries arising from systemic arteries-thoracic aorta, subclavian artery, innominate artery, internal mammary artery, etc. In our country, only 23 cases were reported previously and the majority was intralobar pulmonary sequestration except 2 cases. The patient was 17 year-old man and admitted due to intermittent cough, productive sputum and fever for 8 years. On simple chest P \ulcornerA view, multiple cysts with air-fluid levels were located at left lower lobe area. Aortogram revealed two aberrant arteries arising from thoracic aorta just above the diaphragm. On the operative field, the arteries were 0.7 and 0.3 cm in diameter. Left lower lobectomy was done with ligation of aberrant arteries. The patient was recovered and discharged uneventfully.

• Journal of Chest Surgery
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• v.28 no.8
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• pp.792-796
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• 1995

The pulmonary sequestration is a rare congenital malformation of the lung, concerning about the abnormal feeding systemic artery, may happen a serious complication of bleeding during operation if not recognized before operation. We experienced a case of bilateral intralobar pulmonary sequestration preoperatively confirmed by aortogram. An Aortogram demonstrated a anomalous systemic artery arising from thoracic aorta just above the diaphragm. The artery bifurcated and supplied areas of both right and left lower lobes. On the operative field, left lower lobectomy was done with devision and ligation of left branch of anomalous artery and triple ligation of remained branch of anomalous artery was done. Postoperative course was uneventful. She was discharged on postoperative seventeenth day.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.356-362
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• 2003

Background: Intralobar and extralobar pulmonary sequestrations have been considered as congenital lesions that occur at different stages of embryonic life. However, most cases of intralobar pulmonary sequestration (IPS) seem to have an acquired origin, as they are absent in infants and associated anomalies are relatively, uncommon among them. Material and Method: The cases of 25 patients who were diagnosed as IPS after surgical resection from December, 1985 to July, 2002 were included in this study. The medical records wire retrospectively reviewed and the clinical characteristics were age at operation; gender; symptoms at presentation; presence of congenital anomalies; combined diseases; preoperative studies and diagnosis; location of the lesion; method of surgical resection; origin, size and numbers of aberrant artery; histopathological findings; and postoperative complications. Result: There were 17 (68%) female patients and 8 (32%) male patients, their ages ranged from 1 to 57 and mean value was 23 years old. Though 14 patients (56%) complained of respiratory symptoms such as pneumonia and recurrent respiratory infections, a large number of patients (44%) were asymptomatic or had chest pain only when the lesion was discovered. Only 8 patients (32%) were diagnosed as pulmonary sequestration preoperatively and 8 (32%) were suspected as mediastinal or lung tumor, 5 (20%) were congenital or acquired cystic lung disease, and 4 (16%) were lung abscess or bronchiectasis, respectively. The majority of aberrant arteries (86.4%) confirmed during the operation were originated from thoracic aorta and 2 were thoracic and abdominal aorta, 1 was abdominal aorta, respectively. The younger patients (less than 10 years old) had more other congenital anomalies (30% vs 6.7%) but the proportion of congenital IPS was not significantly different (10% vs 6.7%, p>0.05) compared with elder patients. Histopathologically, almost all lesions showed chronic inflammation, cystic changes and similar pleural adhesions regardless of age. Conclusion: The large portion of the patients with IPS (44%) was clinically asymptomatic or presented non-respiratory symptoms at diagnosis and likely to be diagnosed as mediastinal or lung tumor especially in elder patients. Though the younger patients had more other congenital anomalies, most cases of IPS proved to be acquired lesions in terms of the histopathlogical findings and the proportion of congenital evidences.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1206-1211
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• 1998

Background: Pulmonary sequestration is not common and it's diagnosis needs special care such as an aortogram ar tomography. Material and Method: We have experienced 13 patients who had pulmonary sequestration from January 1990 to September 1997. Result: Six men and seven women were treated and their mean age was 25.8±14.3 years. Their chief complaints were coughing, chest pain, and no symptoms in decreasing order. There were nine intralobar(ILS) and three extralobar(ELS) pulmonary sequestrations and one patient had both. There was no preference in location of either left or right. They were mainly diagnosed by aortography and their feeding arteries commonly originated from the lower thoracic aorta. The patients with ILS were treated by lobectomy and those with ELS by sequestrectomy. Conclusion: to treat pulmonary sequestration properhy, aortogram or chest CT is warranted to iidenty the abnormal origin of feeding artery.

• Tuberculosis and Respiratory Diseases
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• v.72 no.2
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• pp.187-190
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• 2012

Pulmonary sequestration is a rare congenital anomaly of the lung in which it is separately supplied from the aorta or one of its branches. Bilateral pulmonary sequestration is very rare, particularly in adults. In bilateral pulmonary sequestration, resection of both sides is usually recommended if both sides are infected and symptomatic. We report the case of a 37-year-old female patient with bilateral intralobar pulmonary sequestration treated by staged bilateral lower lobectomy.

• Journal of Chest Surgery
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• v.28 no.8
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• pp.797-800
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• 1995

Pulmonary sequestration is an uncommon congenital pulmonary malformation characterized by presence of nonfunctioning lung tissue which receives its blood supply mostly from the anomalous systemic arteries - descending thoracic aorta or abdominal aorta, subclavian artery, innominated artery and internal mammary artery, etc. In our country, 39 cases were reported previously. The patient was a 40 years old woman and admitted due to productive cough for 1 year. The chest X-ray and chest C-T showed a dense mass containing a large cavity with air-fluid level and multiple radiolucent cysts in the right lower lung field. On the operative field, we could identify an aberrant large artery [ $\phi$7mm which arose directly from the descending thoracic aorta at eighth thoracic spinal level and fed the sequestrated portion of the right lower lobe. The aberrant artery was double ligation after division. Only sequestrated lobe on the superolateral lesion of the right lower lobe was resected because of nonseparated lobes in all the right lobes. An abnormal vein and bronchiole were ligated with black silk. The patient`s postoperative course was unevenful.

• Journal of Chest Surgery
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• v.34 no.6
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• pp.502-505
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• 2001

Pulmonary sequestration is an abnormal lung tissue that does not communicate with tracheobronchial tree, and that receives blood supply from anomalous arteries. Pulmonary sequestration is divided into two anatomical forms, intralobar and extralobar. Extralobar pulmonary sequestration is usually located between the diaphragm and the lower lobe and has systemic arterial supply and venous drainage, and most patients are diagnosed in their infancy. We report an extralobar pulmonary sequestration located between the right upper lobe and the lower lobe in a 48-year-old female adult, which has anomalous blood supply from the right pulmonary artery and venous drainage directly into the left atrium.

• Korean Journal of Veterinary Research
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• v.27 no.2
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• pp.157-166
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• 1987

The distribution of hepatic veins within the liver in 28 Korean native cattles were observed. Vinylite solution was injected into hepatic veins of seventeen specimens for cast preparation. The angiography was prepared in eleven specimens by injecting 30% barium sulfate solution into hepatic veins, and then radiographed on a X-ray apparatus (Shimadzu 800 MA 120 Kvp). 1. About two thirds or three quarters of the circumference of the Vena cava caudalis was embedded in the liver. The embedded portion was about 14~19cm in length. 2. The principal branches of the hepatic veins were Vena hepatica sinistra, Vena hepatica media, Vena hepatica dextra and Vena hepatica dorsolateralis; the three main hepatic veins were Vena hepatica sinistra, Vena hepatica media and Vena hepatica dextra. 3. The Vena hepatica sinistra joins the Vena cava caudal is near the esophageal impression of the liver. It gave off three or five branches to the left lobe. 4. The Vena hepatica media joined at the Vena cava caudalis close to the Vena hepatica sinistra. In all cases, Vena hepatica media opened near the diaphragmatic part of the liver than the Vena hepatica sinistra. It ran obliquely through the medial part of right lobe and quadrate lobe, giving off branches on each side. 5. The Vena hepatica dextra consisted of one(25 cases, 89.29%) or two separate veins(3 cases, 10.71%), joining to the Vena cava caudalis between the right and caudate lobes. 6. The flap of membranous tissue covered the dorsal half of the entrance of the Vena hepatica sinistra, media et dextra into the Vena cava caudalis. 7. The vestige of the ductus venosus persisted in the 12~18 months old cattles. 8. The anastomosis was observed in the intralobar and interlobar areas.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.698-706
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• 1990

Congenital Cystic Lung Disease is a spectrum of closed related anomalies that arise during an early stage of embryonic lung bud maturation-namely bronchogenic cyst, congenital lobar emphysema, pulmonary sequestration and congenital cystic adenomatoid malformation. And they show similar surgical strategies. So they are called as the term bronchopulmonary-foregut malformations, firstly proposed by Gerle[1968]. From Aug. 1979 to Aug 1989, 47 patients were operated upon on Dept. of Thoracic & Cardiovascular Surgery at the CUMC. There were 21 females and 26 males ranging in age from age of 21 day to age of 56 year [15 cases under 15 years old]. 30 patients had bronchogenic cysts - 23 of intrapulmonary type, 7 of mediastinal type in location. Affected lobes and locations were as follows: 11 in upper lobe, 3 in middle lobe, 11 in lower lobe and anterosuperior, middle, and posterior mediastinal type were 3, 2, 2 respectively. There were 9 pulmonary sequestrations[all intralobar type] with the distribution of 5 in right lower lobe and 4 in left lower lobe. And associated anomalies were presented with arterial supply originating from thoracic aorta[8 cases], abdominal aorta[1 case] and with venous drainage into azygos vein[1 case]. They all were operated upon lower lobectomy [8 case], pneumonectomy[1 case] in case of pulmonary hypoplasia Congenital lobar emphysema and congenital cystic adenomatoid malformation had 4 cases respectively. Their affected lobes were as follows: the former were 3 in upper lobes, 1 in middle lobe and the latter were 3 in upper lobe, 1 in lower lobe. They were treated with lobectomy and segmentectomy. Diagnosis was aided by chest X - ray, bronchography, aortography, DSA and CT scan, They all were confirmed by pathologic exams. There were no hospital death but few minor morbidities such as, atelectasis-pneumonia[2], wound infection[2], prolonged chest tube placement[2]. We experienced surgical treatments of 47 cases for 10 years and reported them with literature review.