view
Answer to Case of the Week: Jul 1-Jul 8, 2010

15-year-old female with new diagnosis of dextrocardia and pulmonary hypertension.


 




The right lung is hypoplastic, as is the right pulmonary artery. In addition, anomalous pulmonary venous drainage of the right upper and middle lobes and much of the right lower lobe is seen extending into a large anomalous vein that joins the IVC.

Diagnosis: Venolobar syndrome (scimitar syndrome) and likely sequestration.

The study demonstrates that although the heart is positioned in the right hemithorax, the cardiac looping is normal, with the left ventricle seen to lie to the left of the morphologic right ventricle. The right lung is hypoplastic, as is the right pulmonary artery. In addition, anomalous pulmonary venous drainage of the right upper and middle lobes and much of the right lower lobe is seen extending into a large anomalous vein that joins the IVC. Only a single vein is seen to enter from the right lower lobe into the left atrium.

 

In addition, an anomalous arterial structure is seem to extend from the upper abdominal aorta into the right lung base, likely supplying a sequestration. Finally, there is a common origin of the celiac axis and mesenteric artery, the so-called celiomesenteric trunk.


Residents Submitting Correct Diagnosis - Case of the Week
Radiology
Pediatrics
VCU Resident
  • Jonathan Ha
  • Aaron Nordgren
  • Jeremy Camden
  • Karen Gerlach
  • Brian Strife
  • Mack Hendrix
  • Brian Deuell
  • Madison McCulloch
  • Fatmeh Diab
    Others
  • Nishard AbdeenCanada
  • Wael NemattallaEgypt
  • Shashidharreddy EtikaalaIndia
  • JAMAL ABAZIDSyrian Arab Republic
  • Monika BagadeIndia
  • Shanaree MuzinichUnited States of America
  • Sema YildizTurkey
  • Trevor WatkinsAustralia
  • John KirkhamUnited States of America
  • Sanjeev ChoudriIndia
  • Jason AllenUnited States of America
  • Ignasius JapparSingapore
  • PRAGATI KUMARUnited States of America
  • Rajesh SIndia
  • Ashlesha UdareIndia
  • Sarwanand KhetpalPakistan
  • Ramazan JafariIslamic Republic of Iran
  • Georgios BarmpaliosGreece
  • M JIndia

    Disclaimer: This information is intended solely for resident review of presented cases which may or may not be pathologically proven. Information is derived from a number of published sources of varying reliability and does not represent original research from the institution. It is not intended to be comprehensive and should therefore not substitute for careful review of the literature.