SESSION TITLE: Fellow Case Report Slide: Pulmonary Critical Care Disorders: Think Twice
SESSION TYPE: Affiliate Case Report Slide
PRESENTED ON: Sunday, October 23, 2016 at 10:45 AM - 12:00 PM
INTRODUCTION: Pulmonary sequestrations are a rare congenital anomaly of the lung, rarely diagnosed in adults and rarely found in the right middle lobe (RML).
CASE PRESENTATION: A 68 year old woman with granulomatous lung disease, right middle lobe and right lower lobe bronchiectasis, and prior history of massive hemoptysis treated with bronchial artery embolization presented with multiple episodes of bronchitis and pneumonia before developing recurrent episodes of gross hemoptysis. Bronchoscopy demonstrated recent but no active bleeding which seemed to localize to the RML. There were no malignant cells on bronchial wash. With continued hemoptysis over a month later, a video-assisted thorascopic surgery for a right middle lobe lobectomy was planned. Review of computerized tomography images performed with intravenous contrast suggested a feeding artery originating from the right renal artery, therefore to mitigate intraoperative bleeding, a coil embolization of the feeding artery was performed. Pathology was consistent with intralobar pulmonary sequestration. Intraoperative wound cultures grew Pseudomonas aeruginosa species identical to previous sputum cultures.