Pulmonary pseudosequestration in an infant: a case report

Bronchopulmonary vascular malformations constitute a broad spectrum of developmental disorders in which a part of the lung is perfused exclusively from the systemic arterial tree with or without tracheobronchial communication. Pseudosequestration is a rare congenital pulmonary anomaly involving a lung segment with abnormal systemic arterial supply but a preserved connection to the bronchial tree. We present the case of a 5-month-old male referred for evaluation of a cardiac murmur. Initial investigations, including laboratory tests and chest X-ray, revealed ground-glass opacities in the left lung, prompting further imaging. Thoracic computed tomography (CT) and CT angiography demonstrated an aberrant systemic artery originating from the descending aorta and supplying the left lower lobe. Digital subtraction angiography (DSA) was subsequently performed to rule out vascular malformations and confirmed the diagnosis of pseudosequestration. Endovascular treatment was successfully completed with coil embolization and occlusion of the aberrant vessel using an Amplatzer Vascular Plug. The patient remained asymptomatic during a 20-month follow-up period. The case underscores the critical role of early recognition and noninvasive imaging in managing rare congenital pulmonary vascular anomalies.