Coexistent Congenital Diaphragmatic Hernia with Extrapulmonary Sequestration

Abstract

Bronchopulmonary foregut malformations are a heterogeneous but interrelated group of abnormalities that may contain more than one histologic feature. It is helpful to be familiar with the presentation and imaging features of bronchopulmonary foregut malformations presenting as a congenital mass or mass-like lesion, as imaging plays a central role in the evaluation of these lesions since, when symptomatic, clinical features are usually nonspecific. With imaging, the presence of other associated lesions can be determined, facilitating appropriate management to prevent the potential complications. We report a case of coexisting extralobar pulmonary sequestration and ipsilateral diaphragmatic hernia in a term neonate.

Bochdaleck hernia and pulmonary sequestration: case report of an unusual association

“…The sequestrated lung is supplied by an anomalous artery arising from the aorta and its venous drainage is via the azygous system, the pulmonary veins, or the inferior vena cava. In some cases, the mass effect sequestration is speculated to have a protective effect in concomitant CDH, delaying the herniation of abdominal contents until after delivery and allowing prenatal lung development 3 .…”

“…Neonate liver hernia has a poorer prognosis out of all BH 2 . About 50-60% of affected individuals have isolated CDH; the remainder have complex CDH, that is, CDH occurring with additional malformations 3 . One of the more common pulmonary anomalies found with CDH is extralobar bronchopulmonary sequestration (BPS) 4 .…”

“…One of the more common pulmonary anomalies found with CDH is extralobar bronchopulmonary sequestration (BPS) 4 . More than 50% of cases with CDH are detected prenatally through ultrasound examination 3 .…”

Sonographic Evaluation of a Fetal Right-Sided Diaphragmatic Hernia: A Case Study

“…18 A feeding artery usually branches off the thoracic or abdominal aorta in cases of pulmonary sequestration. 19 The best way to discriminate pulmonary sequestration from a diaphragmatic hernia is to locate a feeding vessel to any foreign structure in the chest cavity. 19 Another differential associated with CDH is congenital pulmonary airway malformation (CPAM), which is a developmental abnormality of the lung that results in cell death to the tissue.…”

“…19 The best way to discriminate pulmonary sequestration from a diaphragmatic hernia is to locate a feeding vessel to any foreign structure in the chest cavity. 19 Another differential associated with CDH is congenital pulmonary airway malformation (CPAM), which is a developmental abnormality of the lung that results in cell death to the tissue. 20 Solid or cystic masses can form in the lungs, which can cause a mediastinum shift.…”