Work

Complex case of congenital pulmonary sequestration with successful “EXIT” procedure

Year: 2025

Type: article

Abstract: The ex-utero intrapartum treatment (EXIT) procedure preserves fetal oxygenation via the umbilical cord in urgent respiratory distress. We report a rare case of congenital extralobar pulmonary sequestration with pedicle torsion. A 22-year-old primigravida at 29 + 4 weeks presented with a fetal supradiaphragmatic mass, hydrothorax, and cardiac displacement; fetal magnetic resonance imaging (MRI) confirmed pulmonary sequestration. Rapid fetal deterioration led to the termination of the pregnancy and the application of ex-utero intrapartum treatment procedure during Cesarean section. Before cord clamping, intubation along with thoracocentesis enabled neonatal breathing. The 2140 g newborn required intensive care for respiratory distress, heart failure, and pulmonary hypertension and was discharged stable after 3 weeks. Elective thoracoscopy at the age of 6 months removed the sequestration, confirming pedicle torsion; recovery was uneventful. This case highlights the importance of early diagnosis, multidisciplinary collaboration, and timely use of ex-utero intrapartum treatment to manage life-threatening fetal lung anomalies.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf1066

Authors: Rūta Bernatavičienė, Gabija Pikturnaitė, Gilvydas Verkauskas, Arūnas Strumila

Institutions: Vilnius University, Vilnius University Hospital Santariskiu Klinikos

Language: English

Topic: Congenital Diaphragmatic Hernia Studies

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000