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Intralobar SequestrationExtralobar Sequestration
_____________________________________________
75-85%

Systemic arterial supply

Pulmonary venous drainage

No investing pleura

Presents usually in adulthood

Equal sex incidence

L:R 3:2

Associated anomalies (14%)Anomalies: Skeletal,  foregut duplication cysts, venolobar syndrome, cardiac, renal.
15-25%

Systemic arterial supply

Systemic venous drainage

Own pleural investiture

Presents usually in childhood

M:F 4:1

L:R  4:1

Associated anomalies (50-65%)Anomalies: Diaphragmatic hernias, CCAM, venolobar syndrome, foregut duplication cysts, pectus, PAPVR, pericardial absence, tracheoesophageal fistula, renal and vertebral anomalies










Congenital
IdiopathicInfantile (<4,boys, 90%dextroconcavee, 90% resolve)
Juvenile (4-10,girls, progressive)
Adolescent (>10, more frequently female and laevoconcave)
Neuromuscular  Polio, Myelomeningocoele, Cerebral Palsy, Muscular dystrophies
Meso/neuroectodermalNeurofibromatosis (short segment), Marfans, Homocystinuria
PainfulOsteoblastoma/Osteoid osteoma, Intraspinal tumour, Infection
Miscellaneous Radiotherapy, Compensatory in leg length discrepancy













































"Pulmonary nodules"

Senior and Junior Cases of the day- May 16th









Control
Full KUB (expiration) and Coned Renal (inspiration). Look for calcifications, different respiratory phases allow differentiation of calculi from faecal material. Tomograms may exclude calcium (3-4 will cover all kidney)
Immediate (60secs)
Coned renal. Evaluate symmetrical renal contours (size, position, scarring, vascular symmetry of enhancement). Tomograms may show parenchymal mass lesions.
5 mins
Coned renal. Confirm symmetric bilateral excretion - can now apply compression
10 min (post comp)
Coned Renal. Evaluate symmetry and margins of PC system. Obliques may show calyces better. Tomograms are only occasionally helpful to show intrapelvic filling defects.
15min (comp. release)    
Full KUB. Evaluate ureters and bladder. If you need to see ureters better, prone or oblique images may help.
Post void
Full KUB. Bladder post void residual or masses. Confirm emptying of upper tracts.




Intraluminal    Clots, lucent calculi, sloughed papillae, air
WallMalignancy, Clot, Papilloma, Pyeloureteritis Cystica
ExtrinsicCyst, Mass, Renal sinus lipomatosis, Cysts, Vascular impression, Collateral vessels.
















 

 
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