Unusual echocardiographic finding leading to diagnosis of pulmonary sequestration

Abstract

Pulmonary sequestration is an embryonic mass of non- functioning lung tissue that does not communicate with the tracheobronchial tree and has a reported incidence of 0.15%-6.4% of all the pulmonary malformations. This anomaly is classified as either intralobar or extralobar with the later variety lying outside the normal investment of visceral pleura. The arterial supply is predominantly by an anomalous artery usually arising from either abdominal or thoracic aorta, while the venous drainage occurs commonly via systemic rather than pulmonary veins. Identification of the anomalous arterial supply has therapeutic implication because the majority of infants clinically present large shunt lesions attributed to these channels in early infancy. The diagnosis in such cases is usually established by computed tomography (CT), angiography, magnetic resonance angiography and conventional angiography. This article reports a 28 day old neonate who presented with features of large shunt lesion, in which echocardiography was instrumental in the diagnosis of a large collateral supplying the sequestrated lung.