Intra-abdominal pulmonary secuestration as an exceptional cause of abdominal mass in the adult

• Published in: International journal of surgery case reports 2013-01, Vol.4 (11), p.997-999
• Main Authors: Moreno-Sanz, C, Herrero Bogajo, M.L, Picazo-Yeste, J, Morandeira Rivas, A, Manzanera-Diaz, M, Sedano-Vizcaino, C
• Format: Article
• Language: English
• Subjects: Abdominal mass; Laparoscopy; Pulmonary sequestration; Surgery
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2013.08.019

Abstract INTRODUCTION Pulmonary sequestration (PS) is an extremely rare malformation defined as a portion of lung tissue isolated from the pulmonary system. PSs are classified into intralobar type and intra-abdominal PS that represents only 2.5% of cases. There are 20 cases of PS reported in adults and only two were managed by laparoscopic approach. We report a case of intra-abdominal PS mimicking a gastroesophageal duplication cyst in an adult. Besides its rarity, this is the first intra-abdominal PS in an adult managed by an anterior laparoscopic approach. PRESENTATION OF CASE A 60-year-old female patient had had epigastric and left upper quadrant pain for several days. Physical examination was normal. Image test were consistent with a gastroesophageal duplication. The patient was taken to the operating room for laparoscopic exploration and resection. The pathological diagnosis was extralobar pulmonary sequestration. DISCUSSION Less than 20 cases of PS have been reported in adults and only two cases were managed by a lateral laparoscopic approach. In contrast to these reports, we used an anterior approach due to the GEJ suspected origin of the mass. CONCLUSION Extralobar intra-abdominal PS is an extremely rare condition during adulthood but this diagnosis should be included in the differential diagnosis of a left-sided suprarenal mass. Due to the difficulty in achieving a definitive preoperative diagnosis, surgery is recommended. Laparoscopic resection is safe and effective but careful preoperative imaging studies are recommended in order to plan the most suitable approach.