A rare case of diaphragmatic hernia combined with extralobar pulmonary sequestration: a case report

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BACKGROUND: According to the literature, the combination of extralobar sequestration with diaphragmatic hernia is observed in 12–16% of patients with pulmonary sequestration. The authors present a clinical case of these two pathologies combined. None of the congenital defects was diagnosed in the prenatal period. A pulmonary sequester with an atypical blood vessel was revealed intraoperatively.

CLINICAL CASE DESCRIPTION: А diaphragmatic hernia was diagnosed at the first hours after the birth because the newborn baby developed respiratory failure and needed resuscitation measures. An overview X-ray image of the chest organs revealed a left-sided false diaphragmatic hernia. Surgical intervention thoracoscopy was performed on the 2nd day of newborn’s life. During the surgery additional malformation was revealed. The pulmonary sequestration was noted after the organs were immersed into the abdominal cavity. Surgical manipulations — removal of pulmonary sequestration and plastic defect of the diaphragm — was successful.

CONCLUSION: It is very important to increase the professional attention of pediatric specialists — neonatologists, pediatricians, intensive care specialists, pediatric surgeons, specialists of antenatal ultrasound diagnostics — not only to the problem of pulmonary sequestration, but also to the problem of congenital malformations of the chest organs in general.

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作者简介

Roman Sharoglazov

Krasnoyarsk Regional Clinical Centre for Maternal and Child Health

编辑信件的主要联系方式.
Email: Romancux@mail.ru
ORCID iD: 0009-0000-6959-3172

MD

俄罗斯联邦, Krasnoyarsk

Mikhail Sharoglazov

Krasnoyarsk Regional Clinical Centre for Maternal and Child Health

Email: mihail.mih@mail.ru
ORCID iD: 0000-0002-6936-1678

MD

俄罗斯联邦, Krasnoyarsk

David Chubko

Krasnoyarsk Regional Clinical Centre for Maternal and Child Health; Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: chubko.73@mail.ru
ORCID iD: 0000-0003-2269-945X

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Krasnoyarsk; Krasnoyarsk

Svetlana Falaleeva

Krasnoyarsk Regional Clinical Centre for Maternal and Child Health; Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: so-falaleeva@yandex.ru
ORCID iD: 0000-0003-3481-4689
SPIN 代码: 5138-9029

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Krasnoyarsk; Krasnoyarsk

Tatiana Taranushenko

Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: tetar@rambler.ru
ORCID iD: 0000-0003-2500-8001
SPIN 代码: 4777-0283

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, Krasnoyarsk

参考

  1. Razumovsky AY, Geraskin AV, Sharipov AM, et al. Endoscopic treatment of lung sequestration in children. Russian Journal of Pediatric Surgery. 2012;(5):4–8. EDN: PTURWB
  2. Tumanova UN, Dorofeeva EI, PodurovskayaYL, et al. Pulmonary sequestration: Classification, diagnostics, treatment. Pediatriya. Zhurnal im. G.N. Speranskogo. 2018;97(2):163–171. EDN: TGEMMB doi: 10.24110/0031-403X-2018-97-2-163-171
  3. Oreglio C, Tocchioni F, Ghionzoli M, et al. Intradiaphragmatic pulmonary sequestrations: A surgical challenge. Case series. Front. Surg. 2023;10:1181007. EDN: LVITFG doi: 10.3389/fsurg.2023.1181007
  4. Patrikeeva TV, Karavaeva SA, Kotin AN, et al. Extrathoracic lung sequestration in newborns: Cases report. Russ J Pediatric Surg Anesthesia Intensive Care. 2021;11(3):389–394. EDN: DMWMKF doi: 10.17816/psaic986
  5. Okunev NA, Kemaev AB, Okuneva AI, et al. Pulmonary sequestration: Case report. Russian Journal of Pediatric Surgery. 2016;20(3):164–166. EDN: WAXAOZ doi: 10.18821/1560-9510-20-3-164-166
  6. Kozlov YA, Kovalkov KA, Poloyan SS, et al. Endosurgical technologies for treatment of bronchopulmonary sequestration in children. Pediatriya. Zhurnal im. G.N. Speranskogo. 2021;100(5):14–20. EDN: ZIZPOK doi: 10.24110/0031-403X-2021-100-5-14-20
  7. Sar AS, Haspekov DV, Prutova OR, et al. Pulmonary sequestrationin children. Russ J Pediatric Surg Anesthesia Intensive Care. 2021;11(S):126. (In Russ.) EDN: SJOTRG
  8. Wei Y, Li F. Pulmonary sequestration: A retrospective analysis of 2625 cases in China. Eur J Cardiothorac Surg. 2011;40(1):e39–42. doi: 10.1016/j.ejcts.2011.01.080

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1. JATS XML
2. Fig. 1. X-ray of the chest and abdominal cavity immediately after birth.

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3. Fig. 2. Left thoracoscopy: a — view of the left pleural cavity, b — view of the pleural cavity at the stage of herniated organs reduction, с — the Bochdalek defect of the diaphragm dome, d — reduced left lung, e — the sequestration and its feeding vessels, f — ligation of the sequestration vessels, g — view of the diaphragm after reconstruction.

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4. Fig. 3. Chest X-ray: a — on the 1st day after surgery, b — on the 3rd day after surgery, c — on the 7th day after surgery.

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版权所有 © Sharoglazov R.M., Sharoglazov M.M., Chubko D.M., Falaleeva S.O., Taranushenko T.E., 2024

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