Hyperlucent lung. Pathophysiology and surgical management

289

ABSTRACTS

complete cervical fusion), were studied and associated abnormalities and problems are discussed.- -Anrhony H. Alter

Ashcrqfl

THORAX and

Non-neoplastic

Vascular

pressions

Subclavicular

Report

of the

of Three

ond 1.

Cases.

L. Aloin.

(January-February),

Nervous Area

Com-

The

in Children.

P. Rigoult, J. P. Podovoni,

Ann.

Chir.

Infant.

1547-57

1974.

The authors had the rare opportunity to observe three children presenting with symptoms of subclavicular compression. In one case a fibrous

band

between

was found; the others

coracoid suffered

and from

clavicula a cervical

rib and an anomaly of the first rib, respectively. In childhood the symptoms can be clearly attrlbured

to the malformation,

arthrosis

of

cervical

arteriosclerosis

joints

not

yet

or

being

a

problem. The importance of angiography for the diagnosis is stressed. The authors plead for early treatment of these anomalies, even if the presenting symptoms are not yet very severe, since it is relatively easy to remove the obstacle, and, on the other hand, late complicatlons of untreated cases are extremely severe. (; EJRli Hyperlucent

lung.

Management. W.

C.

Seoly.

ment in the patient’s symptoms. Of those seven patients who did not undergo operation, awareness of the lesion allowed prompt medical management and relief of symptoms.-Keirh W.

Pathophysiology

and

Spectrum

of

the

Scimitar

Syndrome.

Farnsworth end J. L. Ankeney. J. Thoroc. VCISC. Surg. 68:37-42 (July), 1974.

A. E. Cardio-

The scimitar syndrome is a variable rightlung malformation in which the outstanding feature is partial or complete anomalous pulmonary venous drainage into the inferior vena cava. The “scimitar sign” is the x-ray appearance of the anomalous vein passing inferiorly to the diaphragm. Two patients are presented. One was a neonate who had an opaque right chest with shift of the heart

and

mediastinum

to

the

right

sign.“) He died and at autopsy the pulmonary artery supply was from the abdominal aorta and the venous drainage to the inferior vena cava. The lung was hypoplastic and contained no alvecli. This case should have been classified as a sequestered lung. The sccond patient was an adult with a classic “scimitar sign.” At operation the anomalous pulmonary vein was sutured to the left atrium. Fifteen references. --- Thomas M. Holder

(There was no “scimitar

Surgical

W. G. Wolfe, R. W. Anderson, and Ann. Thorac. Surg. 18:172-185

Cardiovascular of Pulmonary

and

Respiratory

Sequestration

Manifestations

in Childhood.

J. J.

P. T. Osfrow, J. Murphy, and J. A. Holler, Jr. Ann Thorac. Surg. 18:286-294 White, J. S. Donahoo,

(August), 1974.

Thirteen adult patients with hyperlucent lung are presented. Four of these cases were congenital with unilateral absence or marked hypoplasia of the pulmonary artery. Nine were acquired as a result of repeated chronic respiratory infections. Two of these nine patients had onset of symptoms in early childhood with the aspiratlon of foreign bodies. In all 13 patients recurrent infections and hemoptysis were prominent findings. Normal pulmonary artery blood flow to the involved lung was demonstrated to be absent m all patients, either due to the ac-

(September), 1974.

In reviewing 14 patients with bronchopulmonary sequestration seen at the Johns Hopkins Hospitals between 1960 and 1972, six patients are emphasized as having either

the case of congenital absence of pulmonary artery were rich and tended to produce the major intraoperative problem in this group of were selected for pneupatients. Patients monectomy on the basis of the repeated severe infections and hemoptysis. Removal of the in-

concomitant congenital heart disease or cardlovascular mamfestations of their pulmonary sequestration. The two patients havmg concomitant congenital heart disease had tricuspid atresla and transposition of the great arteries. respectively, without symptoms referable to rhe sequestration. In four patients arteriovenous shunting through the sequestration was thought to be producing symptoms. One of these patients had a mild subvalvular aortic stenosis and mild pulmonary hypertension. After lower lobectomy with removal of the sequestration, the pulmonary artery pressure returned to normal. Another patient had cardiac fallurr

valved lung or lobe produced

reputedly

quired condition or the congenital absence the pulmonary artery. Bronchial collaterals

pulmonary

function

and

no diminution

produced

of in

in

improve-

due to shunt through

tion with a cardiac

output

the sequestra-

slightly

more

than