Bronchopulmonary sequestration

　　First, Etiology

　　It is a congenital anomaly of lung development, where the isolated lung tissue is separated from the normal lung tissue by pleura.

　　Second, Pathogenesis

　　1. Intralobar type:Common, accounting for about 75%. Most are located in the posterior basal segment of the lower lobe of the left lung, adjacent to the spine, followed by the basal segment of the lower lobe of the right lung, and less frequently in the upper lobe. Isolated lung tissue presents with varying degrees of cystic or consolidation, lacking communication with the surrounding normal tracheobronchial tree. Microscopic examination shows infiltration of monocytes and macrophages, along with fibrosis in the lung tissue, and cystic dilation of the bronchi. If the isolated lung tissue communicates with normal lung tissue, purulent secretions can be observed in the lumen, with inflammation cell infiltration in the corresponding lung tissue, such as neutrophils.

　　2. Extralobar type:Less common, accounting for about 25%. They are often located in the posterior basal segment of the lower lobe of the left lung, and can also be located in the mediastinum or below the intestines. The isolated lung tissue is completely separated from the normal lung tissue by pleura, and the cross-section appears brown and spongy. Microscopic examination shows underdeveloped lung tissue, even in the form of cysts. The bronchi of the isolated lung tissue do not communicate with the normal bronchi, so inflammation of the lung tissue is rare. The bronchi are often twisted and expanded to varying degrees. The blood supply of the isolated lung tissue mainly comes from the abdominal aorta or its branches, and is drained through the inferior vena cava, azygos vein, or hemiazygos vein, forming a left-right shunt. However, there are also cases where blood is supplied through the pulmonary artery and drained through the pulmonary veins.

　　Complicated with pneumonia.

　　Pneumonia refers to inflammation of the terminal airways, alveoli, and interstitium of the lung, which can be caused by pathogenic microorganisms, physical and chemical factors, immune injury, allergy, and drug-induced. Bacterial pneumonia is the most common type of pneumonia and one of the most common infectious diseases. The pneumonia commonly referred to in daily life mainly refers to pneumonia caused by bacterial infection, which is also the most common type. Before the application of antibiotics, bacterial pneumonia posed a great health threat to children and the elderly. The emergence and development of antibiotics once significantly reduced the mortality rate of pneumonia, but in recent years, despite the use of powerful antibiotics and effective vaccines, the overall mortality rate of pneumonia has not decreased and even increased.

　　1. Intralobar type:Symptoms usually appear in childhood, mainly表现为下呼吸道感染，such as fever, cough, sputum, and even hemoptysis. The chest auscultation may reveal moist rales, and occasionally, the rupture of a cyst may cause tension pneumothorax and symptoms of shortness of breath. In those with congenital aortic valve stenosis, hemoptysis may occur repeatedly, and even symptoms may be discovered, even without symptoms, which may be detected through routine chest X-ray examination.

　　2. Extralobar type:Most symptoms are not obvious and are often discovered through routine chest X-ray examination, or due to the presence of other congenital malformations.

　　Prevent colds. Colds are generally divided into common cold and influenza. The common cold, known as 'wind damage' in traditional Chinese medicine, is a common respiratory disease caused by various viruses, of which 30%-50% are caused by a certain serotype of rhinovirus. Although the common cold is more prevalent in early winter, it can occur in any season, such as spring and summer, and the pathogenic viruses causing colds in different seasons are not completely the same. The distribution of cold cases is sporadic, does not cause an epidemic, and is often accompanied by bacterial infections. The onset of the common cold is acute, with early symptoms including dry and itchy throat or burning sensation, sneezing, nasal congestion, and runny nose, which starts as clear nasal mucus and becomes thick after 2-3 days; it may be accompanied by sore throat; generally without fever and systemic symptoms, or only with low fever and headache. It usually recovers in 5-7 days.

　　White blood cell count increases in the presence of concurrent infection.

　　1. Chest X-ray:It appears as a shadow with increased and uneven density, clear boundaries, and lobulated shape, or it may be accompanied by single or multiple cystic dilatation shadows, commonly located in the posterior basal segment of the lower lobe and connected with the diaphragm. In cases with concurrent pneumonia, the shadow of pulmonary inflammation infiltration often appears simultaneously in the isolated lung tissue and the adjacent normal lung tissue, but after the inflammation is controlled, the adjacent lung tissue shows normal recovery, while the shadow of the isolated lung tissue still persists.

　　2. Chest CT (spiral CT) scan and magnetic resonance imaging (MRI):It is helpful to observe the anatomical malformation of pulmonary blood vessels, and angiography can determine the source of abnormal blood supply.

　　3. Ultrasound examination:Prenatal ultrasound scanning at 22-33 weeks of gestation may make a diagnosis.

　　What kind of food is good for bronchopulmonary sequestration patients to eat:It is advisable to keep the diet light, eat more vegetables and fruits, reasonably match the diet, and pay attention to adequate nutrition. Patients with bronchopulmonary sequestration should eat more fresh vegetables such as cabbage, spinach, rapeseed, radish, carrots, tomatoes, cucumbers, winter melon, and such as pork, beef, and mutton lungs, as well as loquat, tangerine, pear, lily, jujube, lotus seed, almond, walnut, and honey, which can be beneficial to the body.

　　1. Treatment

　　Recurrent respiratory tract infections should consider surgical treatment, and at the same time, active anti-infection treatment should be carried out. In recent years, it has been reported that surgical resection with video-assisted thoracoscopic surgery has been successful. Those found by prenatal ultrasound scanning can be treated after delivery according to the condition, but those with excessive amniotic fluid may require prenatal treatment.

　　2. Prognosis

　　Surgical resection has a good prognosis.