Jiangfeng Ou1, Xiaoying Lei2, Zhou Fu1, Ying Huang1, Enmei Liu1, Zhengxiu Luo1, Donghong Peng1. 1. Center of Respiratory Diseases, Children's Hospital, Chongqing Medical University Chongqing 400014, China. 2. Department of Hematology, Children's Hospital, Chongqing Medical University Chongqing 400014, China.
Abstract
BACKGROUND: This study aimed to explore clinical features, diagnosis, treatment, and outcomes of children's pulmonary sequestration (PS) to reduce misdiagnosis. METHODS: Clinical records of 48 children with PS in Children's Hospital of Chongqing Medical University between April 1994 and April 2013 were retrieved, and the literature was reviewed. RESULTS: 48 cases were collected, 30 cases confirmed (Group A) and 18 suspicious cases (Group B). In Group A, 16 cases were confirmed before operation by 64-row enhanced CT (4 cases), enhanced CT combined with three-dimensional reconstruction (9 cases), and digital subtraction angiography (3 cases). Misdiagnosis rate was 36.7%, while missed diagnosis rate 10%. 26 cases received surgery and were confirmed finally. Aberrant arterial supply mainly originated from thoracic aorta (22 cases) and abdominal aorta (5 cases). Hypoplasia and chronic inflammation were shown by postoperative histopathological examinations in all children with surgery. There was no operative mortality. Encapsulated pleural effusion occurred in one patient as only post-operation complication. All were discharged after successful treatment. CONCLUSION: Chest X-ray and color Doppler ultrasound can be used for routine screening for PS. Technique of choice for confirmation is three-dimensional chest CT. Identifying anomalous systemic artery is key for confirmed diagnosis. Surgery is recommended as early as possible. X-ray plus ultrasound as routine screening combined with three-dimensional CT for definitive diagnosis and video-assisted thoracoscopic surgery might be best choice for PS in future.
BACKGROUND: This study aimed to explore clinical features, diagnosis, treatment, and outcomes of children's pulmonary sequestration (PS) to reduce misdiagnosis. METHODS: Clinical records of 48 children with PS in Children's Hospital of Chongqing Medical University between April 1994 and April 2013 were retrieved, and the literature was reviewed. RESULTS: 48 cases were collected, 30 cases confirmed (Group A) and 18 suspicious cases (Group B). In Group A, 16 cases were confirmed before operation by 64-row enhanced CT (4 cases), enhanced CT combined with three-dimensional reconstruction (9 cases), and digital subtraction angiography (3 cases). Misdiagnosis rate was 36.7%, while missed diagnosis rate 10%. 26 cases received surgery and were confirmed finally. Aberrant arterial supply mainly originated from thoracic aorta (22 cases) and abdominal aorta (5 cases). Hypoplasia and chronic inflammation were shown by postoperative histopathological examinations in all children with surgery. There was no operative mortality. Encapsulated pleural effusion occurred in one patient as only post-operation complication. All were discharged after successful treatment. CONCLUSION: Chest X-ray and color Doppler ultrasound can be used for routine screening for PS. Technique of choice for confirmation is three-dimensional chest CT. Identifying anomalous systemic artery is key for confirmed diagnosis. Surgery is recommended as early as possible. X-ray plus ultrasound as routine screening combined with three-dimensional CT for definitive diagnosis and video-assisted thoracoscopic surgery might be best choice for PS in future.
Authors: R W Driggers; H Bernstein; M Lantz; G Stetten; C S Escallon; E Perlman; K J Blakemore Journal: Prenat Diagn Date: 2001-05 Impact factor: 3.050
Authors: Yong Won Seong; Chang Hyun Kang; Jin-Tae Kim; Hyun Jong Moon; In Kyu Park; Young Tae Kim Journal: Ann Thorac Surg Date: 2013-02-28 Impact factor: 4.330