Anomalous systemic arterial supply to the basal segment of the lung with giant aberrant artery: a case report
| Autor: | Kaori Ishida, Yohei Taniguchi, Koji Tsuta, Haruaki Hino, Hiroshi Matsui, Natsumi Maru, Tomohiro Murakawa, Shintaro Kuwauchi, Tomohito Saito, Takahiro Utsumi, Nobuya Zempo |
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| Rok vydání: | 2020 |
| Předmět: |
Tunica media
medicine.medical_specialty Staged surgical therapy medicine.medical_treatment lcsh:Surgery Arteriovenous fistula Case Report 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Celiac artery medicine.artery medicine Embolization Anomalous systemic arterial supply to the basal segment of the lung Giant aberrant artery Lung business.industry lcsh:RD1-811 medicine.disease Pulmonary Arteriovenous Fistula medicine.anatomical_structure 030228 respiratory system Descending aorta Radiology Complication business |
| Zdroj: | Surgical Case Reports, Vol 6, Iss 1, Pp 1-5 (2020) Surgical Case Reports |
| ISSN: | 2198-7793 |
| DOI: | 10.1186/s40792-020-01063-w |
| Popis: | Background Anomalous systemic arterial supply to the basal segment of the lung (ABLL) is a relatively rare congenital anomaly characterized by aberrant systemic arterial blood flow to the basal segment of the lung. We experienced a rare presentation of ABLL, in which a giant aberrant artery with the same dimensions as that of the descending aorta flowed from the celiac artery to left lower lobe. Case presentation An otherwise healthy 42-year-old man was referred to our department due to an abnormal chest X-ray. Enhanced computed tomography revealed a huge and winding aberrant artery with mural thrombus originating from the celiac artery and perfusing into the left lower lobe. We diagnosed giant ABLL and considered possible concomitant pulmonary arteriovenous fistula. The diameter of the aberrant artery was > 30 mm and high-pressure flow was assumed; therefore, we performed staged resection of the left lower lobectomy including division of the aberrant artery at the pulmonary ligament and subsequent embolization of the remnant arterial flow uneventfully. Pathologically, the aberrant artery was abundant with elastic fibers, and dissections of the tunica media and mural thrombus were observed; however, arteriovenous fistula was not confirmed. At 6 postoperative months, enhanced computed tomography showed the aberrant artery to be completely occluded without any symptoms. Conclusions We present a case of ABLL that was successfully managed by surgical resection of the left lower lobe with most of the giant aberrant artery and subsequent embolization of the remnant portion. Our study demonstrates that a staged surgical therapy is an acceptable approach for ABLL in case of complication with a giant aberrant artery. |
| Databáze: | OpenAIRE |
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