The additional lung is a congenital anomaly of development at which, except normally created pair of lungs, there is the third lung (or its part) with the main bronchial tube and vessels which are reported with a small circle. The clinical symptomatology at an additional lung arises only at development in it inflammatory or nagnoitelny processes (pneumonia, a tuberculosis infection, an abstsedirovaniye). The diagnosis is confirmed by data of a bronkhoskopiya, bronchography and angiopulmonografiya. Expeditious treatment – removal of an additional lung is shown at emergence in it secondary inflammatory changes.
The additional lung is the additional dizembriogenetichesky formation which is usually reported with airways, is more rare – the isolated site of a geterotopiya of pulmonary fabric. In pulmonology treats seldom found lung malformations. The additional lung is formed during the early period of an embryogenesis as a result of violation of division of primary bronchial kidney probably as a result of influence of harmful endogenous and exogenous factors. In this case the additional bronchial tube departs from a trachea and the separate network of the vessels connected with a small circle of blood supply is formed. The structure of an additional lung corresponds to very tectonics of normal body in a miniature: it is also divided by intershare cracks, is ventilated through a bronchial tube, has a pleural cover and is capable to carry out gas exchange.
Depending on topography distinguish an additional lung:
- trakhealny (connected with a trachea or initial departments of the main bronchial tube)
- intratorakalny (located in a chest cavity, subplevralno)
- intraabdominalny (with zabryushinny localization, by means of a soyedinitelnotkanny tyazh can connect to a gullet and a stomach).
More frequent option of defect is the additional share of a lung differing in an otkhozhdeniye of an additional bronchial tube not from a trachea, and from the main or share bronchial tube. Approximately in 0,5-1% of cases the share of an unpaired vein (or Raysberg's share) – defect at which a part of the top share of the right lung separates as a result of an unusual arrangement of an unpaired vein is found. Anomaly is classified by the nature of blood supply on the following types:
- additional lung (or a share) with usual type of blood supply – the additional pulmonary formation is located in the top floor of the right pleural cavity; has own serous cover; it is aerated at the expense of the bronchial tube departing from a trachea; it krovosnabzhatsya by branches of pulmonary arteries and veins;
- the additional lung (or a share) with abnormal type of blood supply – has atypical localization (in a pleural or abdominal cavity, in the thickness of a diaphragm etc.) and receives blood supply from vessels of a big circle of blood circulation.
In most cases the additional lung has no clinical value. Anomaly can be revealed incidentally, in the course of the bronkhologichesky inspection, a diagnostic torakoskopiya which are carried out in other occasion, or already on autopsy. Quite seldom in an additional lung there can be recurrent pneumonia, tuberculosis, abscess. In this case the clinical symptomatology corresponds to inflammatory or nagnoitelny process.
Standard radiological diagnostics (X-ray analysis of lungs) is supplemented with a bronchography and an angiopulmonografiya – in total these researches help to find bronchial tubes and vessels of an additional lung, to specify topography of additional education. When carrying out a bronkhoskopiya the mouth of the additional bronchial tube departing from a trachea is visualized. The additional lung demands a differentiation with extra share sequestration, a share of an unpaired vein, a trakhealny bronchial tube.
Treatment of an additional lung
Need for expeditious treatment of an additional lung arises in that case when in it the secondary inflammatory changes supporting the course of chronic nagnoitelny processes are formed. In this situation removal of additional pulmonary formations is made. To - and postoperative observation of patients with an additional lung the pulmonologist and the thoracic surgeon carry out.