Intralobar Pulmonary Sequestratıon as an Unusual Cause of Recurrent Hemoptysis
A 26-year-old female patient admitted to our clinic with complaints of cough and mild shortness of breath had an 8-year history of recurrent hemoptysis. Physical examination was normal except for the coarse crackles heard in the lower regions of the left lung. There was no abnormality seen in the laboratory investigations. Pulmonary function tests showed forced vital capacity (FVC): 2.65 l (90% of predicted value), forced expiratory volume in 1 s (FEV1): 2.28 l (86.5% of predicted value), and FEV1/FVC: 96%. These were nearly normal spirometric values. Arterial blood gas analysis (at room air) parameter was found to be normal; pO2: 98.0 mmHg, pCO2: 37.6 mmHg, pH: 7.38, and SaO2: 98%. Contrast-enhanced spiral computed tomography (CT) of the thorax revealed an aberrant vascular structure extending from thoracic aorta to lower left lung and 5 mm in diameter [Figures and ]. We observed increased mucosal vascularization, micro-hemorrhagic foci, and secretions from left lower lobe (LLL) bronchus during fiber optic bronchoscopic examination. Thoracic aortography confirmed the pulmonary sequestration and aberrant arterial vessel from aorta to LLL and venous drainage from sequestrated area to the left atrium [].\nThe left posterolateral thoracotomy was performed and the sequestered tissue was found at the baseline of the LLL of the lung []. Dissection starting from the pulmonary ligament was done and aberrant systemic vascular structures were detected and ligatured with 3/0 prolene. Subsequently, the standard lower lobectomy was performed. Pathological examination of the lung tissue revealed intralobar (ILS) sequestrated lung with focal intra-alveolar hemorrhages (IAH), parenchymal hemorrhages (PH), and vascular congestions []. Postoperatively, the patient did not have any clinical and radiological problems and was discharged 7 days after surgery.