Lung sequestration associated to cystic adenomatoid malformation. A propos of a clinical case

摘要

Lung congenital anomalies comprise a wide number of pathologies. Some are characteristical clinical syndromes, while others are considered only anatomical variations that require no treatment. The congenital lung malformations have an estimated incidence of 2.2% of the whole congenital malformative pathology. Cystic adenomatoid malformation is an abnormal hamartomatous development with bronchiolar proliferation that forms cysts instead of alveoli; and represent 25% of all lung congenital pathologies. Lung sequestration is generally defined as nonfunctioning lung tissue that is in abnormal continuity with the tracheobronchial tree and that is irrigated from the systemic circulation, The clinical case refers to a feminine infant of 3 months of age, who presents respiratory difficulty, humid cough and hyporexia; she is admitted to a hospital center with diagnostic of Low respiratory Infection complicated with blocked empyema. This patient had a prenatal diagnosis of adenomatoid malformation associated to left lung sequestration. At admission the physical examination showed: FC: 122 Ipm FR: 40rpm P: 6200gr; cutaneous mucosal paleness. symmetrical thorax, vesicular murmur diminished in 2/3 of the left lower hemithorax, without aggregates, expiratory groan. Rythmical cardiac sounds. Laboratoryl: Hb: 11,7gr/dl Hto: 35.2%; Leuc: 8600cel/mm3 Neut: 24% Lymph: 54% Glic:97gr/dl Creat:0,3mg% pH:7,30 PO2:80 PCO2:23,3 HCO3:13,3 SatO2:97,4% Na:146mEq/lt K:3,4mEq/lt. Imaging studies confirming prenatal diagnostic are carried out. Antibiotic treatment is administered; ligation of aberrant aortic vessel is performed. Owing to patient clinical improvement she is discharged pending a left lower lobectomy.