Infradiaphragmatic Bronchopulmonary Sequestration In A Premature Newborn: Case Report

Abstract

Introduction: Pulmonary sequestration is a rare disease, which can occur intra or extralobar. It is usually asymptomatic, has good prognosis, and should be suspected in prenatal period. Objective: To document the clinical manifestations, diagnosis, treatment and outcomes of a newborn with infradiaphragmatic pulmonary sequestration, whose suspected diagnosis occurred during the intrauterine period. Case description: Male, late preterm, son of a primiparous mother without comorbidities. An ultrasound performed at 18 weeks and 1 day showed a homogeneous echogenic image on the left, suggestive of pulmonary sequestration. He was born by cesarean section, hypotonic and in apnea, and the umbilical cord was immediately clamped. In neonatal intensive care unit, a chest X-ray was performed and showed a hyperechoic image at the left lung base and deviation in diaphragmatic line. An abdominal ultrasound with Doppler was indicated and performed, showing a suggestive infradiaphragmatic pulmonary sequestration image. The patient was monitored by the surgical team during intra and extra-hospital period. At six months old he underwent computed tomography angiography, which confirmed the diagnosis. At eight months old, he underwent surgical resection, which occurred successfully. Discussion: Infradiaphragmatic pulmonary sequestration - patients type - accounts for less than 1.7% of total. It has an unknown etiology, communicates anomalously with tracheobronchial tree, and has its own blood supply. When clinically present, it manifests in the first months of life, and there is no need for immediate intervention. The diagnosis should be suspected prenatally and treatment usually occurs up to nine months of life.