Among the most frequent pathologies of the abdominal wall are hernias, which are defined as a protrusion of the abdominal organs through any of the weak points of the abdominal wall. They can be spontaneous appearing in weak points of the abdominal wall or along the site of surgical incisions.
Although hernias have been mentioned since ancient times, until after the second half of the 19th century, when the era of modern surgery began, the concept of hernias rarely mentioned incisional ones.
After the introduction of anesthesia and antisepsis, abdominal interventions began to become common and with this, the incidence of incisional hernias was significantly increased. Until after the second world war, the correction of incisional hernias was done using simple sutures, transverse overlapping technique, continuous fascial sutures, etc.
After this period, different synthetic materials were manufactured for the correction of abdominal hernias. The large variety of prosthetic materials that are in use today, both dual and biological, helps in the successful correction of incisional hernias. A new era in the treatment of hernias in general including incisional hernias began with the use of laparoscopic techniques in 1993 by Le Blanc.
Against all these achievements, the correction of incisional hernias continues to remain a real challenge that requires a personalized approach for each patient with the aim of achieving good results and avoiding post-operative complications, of which hernia recurrence remains one of the most serious.
We are presenting a rare case with the simultaneous occurrence of pleuropulmonary blastoma and an intra lobar pulmonary sequestration. Although there have been cases reported previously with pleuropulmonary blastoma associated with congenital pulmonary malformations, the association with an intra lobar pulmonary sequestration is very rare. The patient, a female, 6-month-old child arrived at our pediatric service with the clinic of cough, respiratory distress, and fever after being treated for 2 weeks for left lung bronchopneumonia according clinical signs and radiographic description but without clinical improvements. Contrast enhanced CT images showed the simultaneous presence of 2 different lesions in the left lung, a heterogeneous mass in the superior lobe without delineation with mediastinal structure compatible with a pleuropulmonary blastoma and a consolidation in the inferior lobe with bronchogram present and a systemic vessel feeding compatible with an intra lobar pulmonary sequestration, both confirmed by histologic examinations after the surgical intervention. Although it is very rare, the simultaneous presence of these distinct embryogenic lesions may occur and radiologist should be aware as the imaging diagnosis may be very helpful for the further management of the patient.
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