A Rare Case of Bilateral Pulmonary Sequestration Managed with Embolization and Surgical Resection in a Patient
A 22-year-old male was admitted because of discomfort due to repeated upper respiratory tract infection symptoms, chronic cough, and sputum for several years. There were no abnormal findings reported in the initial laboratory results and electrocardiogram. Chest X-ray and enhanced chest computed tomography (CT) scans were taken; these revealed bilateral cystic lesions on both the lower lobes. Like the chest X-ray, the chest CT also revealed bilateral cystic lesions. In particular, pneumonic consolidations were found on the lesions of the right lower lobe (RLL) (), and both the lesions were fed directly from the thoracic aorta and drained into the pulmonary vein (). On the basis of the CT image analysis of the chest, the patient was diagnosed as having bilateral intralobar pulmonary sequestration on the RLL and left lower lobe (LLL).\nThe patient wanted surgery for repeated chronic cough and sputum. We planned staged bilateral lobectomy for both lungs and prophylactic embolization of the feeding vessels for preventing unexpected hemorrhage during the operation. On hospital day (HD) 1, angiography was done for embolization of feeding vessels of the pulmonary sequestration. Each of them was occluded with embolic coils (). On HD 3, right lower lobectomy of lung with video-assisted thoracic surgery was done because of the pneumonic consolidations.\nThe patient was discharged on postoperative day 10 without surgery of the LLL because of personal schedules and recovery. In the serial outpatient department follow-up, the patient did not feel any respiratory discomfort and was satisfied with the result of angiographic embolization; he refused additional surgery of the LLL.