2023 Volume 59 Issue 1 Pages 61-66
A boy was born 2,641 g in weight at 38 weeks of gestation by planned cesarean section. He was diagnosed as having left pulmonary sequestration at 20 weeks of gestation, and left diaphragmatic hernia was diagnosed on the basis of MRI findings at 34 weeks of gestation. He underwent transabdominal diaphragmatic repair on day 2, but no segmented lung could be seen in the thoracic cavity intraoperatively. Contrast-enhanced computed tomography on day 35 revealed extralobar pulmonary sequestration (ELS) on the left diaphragm, which was fed by the celiac artery and returned to the portal vein. He was asymptomatic, but considering the large size of the feeding artery and the large amount of blood flow to the segmented lung, we performed a thoracoscopic-assisted resection of the segmented lung at 18 months of age. ELS is generally considered to be asymptomatic. ELS with portal venous drainage is extremely rare, and only four cases have been reported in detail, and all of them had infection without specific symptoms. ELS should be resected on the basis of the risks of torsion, infarction, and infection, and thoracoscopic or thoracoscopic-assisted resection is a good indication.
