Treatment for unstable pulmonary sequestration injury in patient with severe blunt trauma: A case report

Abstract

CasePulmonary sequestration is a congenital malformation characterized by nonfunctioning tissue not communicating with the tracheobronchial tree. As the blood pressure in the artery feeding the sequestrated lung tissue is higher than that in the normal pulmonary artery, the risk of massive hemorrhage in pulmonary sequestration is high. We herein present the first case of a severe blunt trauma patient with unstable pulmonary sequestration injury.Outcome and conclusionThe mechanism of pulmonary sequestration injury is vastly different than that of injury to normal lung. We suggest that proximal feeding artery embolization should be performed before surgical intervention in patients with massive hemorrhage of pulmonary sequestration due to severe chest trauma.

Endovascular embolization for pulmonary sequestration in adults: An adjunctive technique to delay surgical intervention

“…However, emergent surgical intervention presents significant complications and is highly dangerous in patients with a difficult to control aberrant blood supply. [1][2]5] Controlling bleeding intraoperatively can be a challenge because the systemic arterial supply of the sequestered lung tissue has a higher blood pressure than a normal pulmonary artery, and any unintentional damage to the aberrant artery can result in life-threatening hemorrhage. [6] Recently, pre-operative management through transcatheter embolization has emerged as an effective option in adults.…”

“…[2,4] ere are also clinical scenarios where emergent surgical intervention presents significant risk of mortality, such as in patients at risk of life-threatening hemorrhage with a source of bleeding that is difficult to control. [5] Emergent endovascular embolization has emerged as an option to achieve hemostasis and allow delayed surgical intervention. Notably, case reports of successful embolization have now been described in adults.…”

“…Notably, case reports of successful embolization have now been described in adults. [1][2][3][4][5][6][7][8][9][10][11] We report two cases of endovascular embolization that further illustrates the utility of emergently stopping hemoptysis, allowing for delayed surgical intervention for pulmonary sequestration.…”