ÇOMAK PARMAKLA SEYREDEN BİR İNTRAPULMONER SEKESTRASYON OLGUSU

Abstract

Otuz bir yaşında erkek hasta, çocukluğundan beri süregelen öksürük, balgam ve ani başlayan göğüs ağrısı yakınmaları ile başvurdu. Fizik muayenesinde sol akciğer bazalinde inspi-ratuar railer ve çomak parmak saptanan hastanın radyolojik incelemesinde sol alt lobda kistik oluşumlar görüldü. Sık enfekte olan bronşiektazi ön tanısıyla sol alt lobektomi uygulanan hastada intralober sekestrasyon saptandı. Bu olgu sunumunda, radyolojik olarak bronşiektazi ile sık karışan pulmoner sekestrasyon, literatür eşliğinde tartışılmakta ve çomak parmağın nadir görülen bir bulgu olduğu vurgulanmaktadır. Dr. Ayşe GÖZÜ, Dr. Nilgün KALAÇ, Dr. Berna Akıncı ÖZYÜREK, Dr. Mahmut GÜLGÖSTEREN, Dr. Nurettin KARAOĞLANOĞLU, Dr. Hatice Esra ÖZAYDIN

Keywords

• Pulmoner sekestrasyon
• intralober
• çomak parmak.

A CASE OF INTRAPULMONARY SEQUESTRATION WITH DIGITAL CLUBBING

Abstract

A 31 year-old male patient presented with cough and sputum ongoing from childhood and chest pain with sudden onset. Inspiratory crackles on the lower zone of the left hemithorax and digital clubbing were detected by physical examination. Radiological investigation revealed cystic formations in the left lower lobe. Left lower lobectomy was performed with the diagnosis of frequently infected bronchiectasis but intralobar sequestration was detected. In this presentation, pulmonary sequestration which is frequently misdiagnosed as bronchiectasis radiologically, has been discussed in the light of literature and it is emphasized that digital clubbing is a rare feature of sequestration.

Keywords

• Pulmonary sequestration
• intralobar
• digital clubbing.

References

1. 1. Louie HW, Martin SM, Mulder DG. Pulmonary sequestration; 17 year experience at UCLA. Am Surg 1993;59(12):801-5.
2. 2. Kamiyoshirara M, Kawashima O, Sakata S, et al. Extra lober pulmonary sequestration in the posterior mediastinum. Scand Cardio-vasc J 2001;35:157-8.
3. 3. Shamji FM, Sachs HJ, Perkins DG. Cystic disease of the lungs. Surg Clin North Am 1988;68(3):581620.
4. 4. Gustafon RA, Murray GF, Warden HE, Hill RC, Rozar GE. Intralobar sequestration; A missed diagnosis. Ann Thorac Surgery 1989;47:841-7.
5. 5. Savic B, Birtel FJ, Tholen W, et al. Lung sequestration: report of seven cases and review of 540 published cases. Thorax 1979;34:96-101.
6. 6. Yuncu G, Gülle A, Ceylan K. Akciğer sekestrasyonu (olgu sunumu). Heybeliada Tıp Bülteni 2001;7:58-61.
7. 7. Yüksel M, Kalaycı G. Konjenital akciğer hastalıkları. Göğüs Cerrahisi, Ed: Yüksel M, Kalaycı G. özlem Grafik Matbaacılık, İstanbul 2001:304-5.
8. 8. O’Mara CS, Baker RR, Jeyasingham K. Pulmonary sequestration; Collective reviews. Surg Gynecol Obstet 1978;147:609-16.

9. 9. Karaoğlanoğlu N, Kürkçüoğlu C, Demircan S, et al. Surgical treatment of pulmonary sequestrations: Results of 10 surgically treated patients. Turk J Med Res 1995;13:185-8.
10. 10. Corbett JH, Humphrey GME. Pulmonary sequestration. Paediatr Respir Rev 2004;5(1):59-68.
11. 11. Sipahi S, Gürsu RU, Koksal C. İntralober pulmoner sekestrasyon vakası ve literatürlerin gözden geçirilmesi. Cerrahpaşa J Med 2000;31:168-71.
12. 12. Sırmalı M, Aydın E, Ağaçkıran Y ve ark. Sağ alt lobda lokalize intralober pulmoner sekestrasyon olgusu. Solunum Hastalıkları 2004;15:55-8.
13. 13. Sugio K, Kanetos, et al. Pulmonary sequestration in older child and in adults. Int Surg 1992;77:102-7.
14. 14. Hekelaar N, van Uffelen R, van Uliet ACM, et al. Primary lymphoepithelioma-like carcinoma within an intralobular sequestration. Eur Respir J 2000;16:1025-7.
15. 15. Hopkins RL, Levine SD, Waring WW.Intralobar sequestration. Demonstration of collateral ventilation by nuclear lung scan. Chest 1982;82:192-3.
16. 16. Tandon M, Warnock ML. Plexogenic angiopathy in pulmonary intralobar sequestrations: pathogenetic mechanisms. Hum Pathol 1993;24: 263-73.
17. 17. Gerie RD, Jaretzki A, Ashley CA, Berne AS, et al. Congenital bronchopulmonary-foregut malformation; pulmonary sequestration communicating with the gastrointestinal tract. N Engl J Med 1968; 278(26): 1413-5.
18. 18. Yaldız S, Türk F, Gürsoy S ve ark. Extralobar pulmonary sequestration in posterior mediastinum. Izmir Göğüs Hastalıkları Dergisi 2004; 18(3): 129-32.
19. 19. Cooke CR. Bronchopulmonary sequestration. Respiratory Care 2006;51(6):6614.
20. 20. Görür R, Yıldızhan A, Yiyit N ve ark. Akciğer sekestrasyonu: Bronşiyektazi nedeniyle öpere edilen 4 genç erişkin olgu. Gülhane Tıp Dergisi 2008;50:39-41.
21. 21. Felker RE, Tonkin ILD. Imaging of pulmonary sequestration. Review Article. Am J Roentgenol 1990;154:241-9.
22. 22. Raemdonck DV, Boeck KD, Devlieger H, et al. Pulmonary sequestration: a comparison between pediatric and adult patients. Eur J Cardiothoracic Surg 2001;19:338-95.
23. 23. Saygı A, Çağlayan B ve ark. Anjiografi ile tanı konmuş bir intrapulmoner sekestrasyon olgusu. Solunum Hastalıktan 1992;3:425-30.
24. 24. Şahin E, Kaptanoğlu M, Nadir A ve ark. Ender bir sekestrasyon olgusu Toraks Dergisi 2004;5(3):216-9.
25. 25. Ocaklı B, Sulu E, Karakurt Z ve ark. Intrapul-monary sequestration: A case report. Turkish Respiratory Journal 2003;4(3): 150-2.
26. 26. Lehnhardt S, Winterer JT, Uhrmeister P. Pulmonary sequestration: demonstration of blood supply with 2D and 3D MR angiography. Eur J Radiol 2002;44:28-32.
27. 27. Aqrabawi HE. Pulmonary sequestration: Case report. Journal of Clinical and Diagnostic Research 2007;1(2):73-5.
28. 28. Luck SR. Congenital bronchopulmonary malformations. Current problems in Surgery 1986;23(4):245-314
29. 29. Tokel K, Boyvat F, Varan B. Coil embolization of pulmonary sequestration in two infants: a safe alternative to surgery. AJR 2000;175:993-5.
30. 30. Dinkel HP, Hoppe H, Striffeler HU, Triller J. Preoperative arterial embolization of intralobar lung sequestration. Radiologie 2001;41:1001-4.
31. 31. Kanazawa S, Miyake T, Ishida A, et al. Intralobar pulmonary sequestration supplied by multiple anomalous arteries: Report of a Case. Surg Today 2001 ;31:701-4.