bronchopulmonary sequestration
Introduction
Introduction to bronchopulmonary isolation Bronchopulmonary sequestration (bronchopulmonary sequestration) is a congenital dysplasia of the lungs. The isolated lung tissue and the normal lung tissue have a pleural membrane to separate them, and receive blood supply from the systemic circulation of the arteries, including both intralobular and extralobal types. It occurs mostly in the early stage of embryonic development and may be accompanied by other types of congenital malformations, such as bronchial esophageal diverticulum, spasm and skeletal abnormalities. basic knowledge The proportion of illness: 0.003% Susceptible people: no specific population Mode of infection: non-infectious Complications: pneumonia
Cause
Causes of bronchopulmonary isolation
(1) Causes of the disease
The lungs are congenitally abnormal, and the isolated lung tissue and the normal lung tissue have a pleura to separate them.
(two) pathogenesis
1. The intralobular type is more common, accounting for about 75%, mostly located in the posterior basal segment of the left lower lobe, adjacent to the spine, followed by the basal segment of the right lower lobe, the upper lobe is less common, and the isolated lung tissue is different. Cystic or consolidation, lack of communication with the surrounding normal tracheobronchial tree, microscopic examination showed mononuclear cells and macrophage infiltration and fibrosis in the lung tissue, bronchial cystic dilatation, if the isolated lung tissue and normal lung tissue traffic, It can be seen that the purulent secretion in the lumen is retained, and the inflammatory cells infiltrate in the lung tissue, such as neutral multinucleated cells. The isolated blood vessels of the lung are usually well-developed elastic arteries, the blood vessels are twisted, the wall is thickened, and the pulmonary artery and pulmonary veins are The systemic blood vessels can form a pre-capillary anastomosis.
2. The leaf type is less common, accounting for about 25%, mostly located in the posterior basal segment of the left lower lobe. It can also be located in the mediastinum or in the intestine. The isolated lung tissue is wrapped by the pleura and completely separated from the normal lung tissue. The cut surface is brown. Sponge-like, microscopic examination revealed lung tissue dysplasia, and even cystic shape. The bronchus isolated from the lung tissue has no communication with the normal bronchus. Therefore, inflammation of the lung tissue is rare, and the bronchus is distorted and expanded to varying degrees. The blood supply of the isolated lung tissue mainly comes from The abdominal aorta or its branches, through the inferior vena cava, azygous or semi-singular vein drainage, form a left-right shunt, but also blood through the pulmonary artery supply and pulmonary vein drainage.
Prevention
Prevention of bronchopulmonary isolation
prevent getting cold.
Complication
Complications of bronchopulmonary isolation Complications pneumonia
Pneumonia.
Symptom
Bronchopulmonary isolation symptoms Common symptoms Purulent hemoptysis
1. The intralobular type usually presents symptoms in childhood, mainly manifested as lower respiratory tract infections such as fever, cough, purulent sputum, and even hemoptysis. The auscultation of the lungs can be heard and wet snoring. Occasionally, the rupture of the cyst causes tension pneumothorax. The symptoms of shortness of breath, accompanied by congenital aortic stenosis, can be repeated hemoptysis, and even found symptoms, even asymptomatic, found by routine chest X-ray examination.
2. Most of the symptoms of the leaf type are not obvious, and are often found by routine chest X-ray examination or by other congenital malformations.
Examine
Examination of bronchopulmonary isolation
Leukocytes are elevated with concomitant infection.
1. The chest X-ray shows a density that is deep and uneven, with clear boundaries, lobulated, or may be accompanied by single or multiple cystic dilatation shadows, often located in the posterior basal segment of the lower lobe, and connected to the iliac crest. In patients with pneumonia, pulmonary inflammatory infiltrates often appear in isolated lung tissue and adjacent normal lung tissue. However, after inflammation control, adjacent lung tissue returns to normal, while isolated lung tissue shadows persist.
2. Chest CT (spiral CT) scan and magnetic resonance imaging (MRI) can help to observe vascular anatomic deformities in the lungs, and angiography can determine the source of abnormal blood vessels.
3. Ultrasound examination Prenatal ultrasound scans of 22 to 33 weeks of gestation may make a diagnosis.
Diagnosis
Diagnosis and identification of bronchopulmonary isolation
According to the history and clinical manifestations, plus pulmonary angiography, it is not difficult to diagnose.
The disease often needs to be differentiated from bronchiectasis, and needs to be differentiated from congenital diaphragmatic hernia. Both of them need to be differentiated from pneumonia, lung abscess and lung tumor.
