Skip to main content
Log in

Identical twins concordant for pulmonary sequestration communicating with the esophagus and discordant for the VACTERL association

  • Case Report
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Communicating bronchopulmonary foregut malformations (CBPFMs) are unusual congenital structures composed of a segment of lung tissue connected to the foregut. We present what we believe is the first reported case of identical twins concordant for CBPFM who are discordant for the VACTERL association. Their nonfunctional lung tissue was successfully removed and the fistulae were corrected, and they are expected to live normal life spans. We review the literature concerning these malformations and the proposed theories of their etiology. This case report of concordance in identical twins suggests that a possible genetic component to CBPFMs cannot be ruled out. The discordance for the VACTERL association implies that the etiology is most likely multifactorial.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

References

  1. Srikanth MS, Ford EG, Stanley P, Mahour GH (1992) Communicating bronchopulmonary foregut malformations: classification and embryogenesis. J Pediatr Surg 27:732–736

    Article  PubMed  CAS  Google Scholar 

  2. Blank RH, Prillaman PE Jr, Minor GR (1967) Congenital esophageal atresia with tracheoesophageal fistula occurring in identical twins. J Thorac Cardiovasc Surg 53:192–196

    PubMed  CAS  Google Scholar 

  3. Ohkuma R (1978) Congenital esophageal atresia with tracheoesophageal fistula in identical twins. J Pediatr Surg 13:361–362

    PubMed  CAS  Google Scholar 

  4. Gerle RD, Jarerzki A III, Ashley CA, Berne AS (1968) Congenital bronchopulmonary foregut malformation: pulmonary sequestration communicating with the gastrointestinal tract. N Engl J Med 278:1413–1419

    Article  PubMed  CAS  Google Scholar 

  5. Heithoff KB, Sane SM, Williams HJ, Jarvis CJ, Carter J, Kane P, Brennom W (1976) Bronchopulmonary foregut malformations: a unifying etiological concept. AJR Am J Roentgenol 126:46–55

    PubMed  CAS  Google Scholar 

  6. Bates M (1968) Total unilateral pulmonary sequestration. Thorax 23:311-315

    Article  PubMed  CAS  Google Scholar 

  7. Borsellino A, Alberti D, Vavassori D, Pericotti S, Cheli M, Locatelli G (2002) Communicating bronchopulmonary foregut malformation involving a mixed sequestration/cystic adenomatoid malformation: a case report. J Pediatr Surg 37:E38

    Article  PubMed  CAS  Google Scholar 

  8. Bretagne MC, Derelle J, Didier F, Bernard C, Olive D, Schmitt M, Hoeffel JC (1988) Communication oesophagienne avec un poumon droit hypoplasique totalement séquestré. J Radiol 69:543–548

    PubMed  CAS  Google Scholar 

  9. Brunken C, Kluth D, Lambrecht W (1997) Extralobäre Lungensequestration mit Fistel zum Oesophagus. Chirurg 68:1020–1022

    Article  PubMed  CAS  Google Scholar 

  10. Evers WB, Vissers R, van Noord JA (1990) Pulmonary sequestration with congenital broncho-oesophageal fistula. Eur Respir J 3:1067-1069

    PubMed  CAS  Google Scholar 

  11. Graves VB, Dahl DD, Power HW (1975) Congenital bronchopulmonary foregut malformation with anomalous pulmonary artery. Radiology 114:223–224

    Google Scholar 

  12. Horigome H, Hirano T, Umesato Y, Kemmorsu H, Joe K (1989) Oesophageal lung with systemic arterial blood supply. Eur J Pediatr 49:72–73

    Article  Google Scholar 

  13. Lane SD, Burko H, Scott HW (1971) Congenital bronchopulmonary-foregut malformation. Radiology 101:291–292

    PubMed  CAS  Google Scholar 

  14. Moscarella AA, Wylie RH (1968) Congenital communication between the esophagus and isolated ectopic pulmonary tissue. J Thorac Cardiovasc Surg 55:672–676

    PubMed  CAS  Google Scholar 

  15. Yoshida J, Ikeda S, Mizumachi S, Sumitomo K, Iwai T, Matsuo K, Tanimura A (1999) Ephiphrenic diverticulum composed of airway components attributed to a bronchopulmonary-foregut malformation: report of a case. Surg Today 29:663–665

    Article  PubMed  CAS  Google Scholar 

  16. Mahour GH, Cohen SR, Woolley MM (1973) Laryngotracheoesophageal cleft associated with esophageal atresia and multiple tracheoesophageal fistulas in a twin. J Thorac Cardiovasc Surg 65:223-226

    PubMed  CAS  Google Scholar 

  17. Benson JE, Olsen MM, Fletcher BD (1985) A spectrum of bronchopulmonary anomalies associated with tracheoesophageal malformations. Pediatr Radiol 15:377–380

    Article  PubMed  CAS  Google Scholar 

  18. Whalen TV Jr, Albin DM, Wooley MM (1987) Esophageal atresia and tracheoesophageal fistula in the twin: anatomic variants. Ann Surg 205:322–323

    Article  PubMed  Google Scholar 

  19. Fowler CL, Pokorny WJ, Wanger ML, Kessler MS (1988) Review of bronchopulmonary foregut malformations. J Pediatr Surg 23:793–797

    Article  PubMed  CAS  Google Scholar 

  20. O’Mara CS, Baker RR, Jeyasingham K (1978) Pulmonary sequestration. Surg Gynecol Obstet 147:609–616

    PubMed  CAS  Google Scholar 

  21. Eizaguirre I, Tovar JA, Conde J (1989) Secuestro pulmonar con fistula esofagobronquial: aportación de dos casos y revisión de la literatura. An Esp Pediatr 31:297–301

    PubMed  CAS  Google Scholar 

  22. King SL, Ladda RL, Shochat SJ (1977) Monozygotic twins concordant for tracheo-esophageal fistula and discordant for the VATER association. Acta Paediatr Scand 66:783–785

    Article  PubMed  CAS  Google Scholar 

  23. Knudtzon J, Jordheim O, Smedsrud B (1986) Twins discordant for VATER association: obstructed labor of the second twin due to ascites and persistent cloaca without communication to the exterior. Acta Obstet Gynecol Scand 65:185–186

    Article  PubMed  CAS  Google Scholar 

  24. Hoffman MA, Superina R, Wesson DE (1989) Unilateral pulmonary agenesis with esophageal atresia and distal tracheoesophageal fistula: report of two cases. J Pediatr Surg 24:1084–1085

    Article  PubMed  CAS  Google Scholar 

  25. Steadland KM, Langham MR Jr, Greene MA, Bagwell CE, Kays DW, Talbert JL (1995) Unilateral pulmonary agenesis, esophageal atresia, and distal tracheoesophageal fistula. Ann Thorac Surg 59:511–513

    Article  PubMed  CAS  Google Scholar 

  26. Takayanagi K, Grochowska E, Abu-el Nas S (1987) Pulmonary agenesis with esophageal atresia and tracheoesophageal fistula. J Pediatr Surg 22:125–126

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Arnold G. Coran.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Becker, J., Hernandez, A., Dipietro, M. et al. Identical twins concordant for pulmonary sequestration communicating with the esophagus and discordant for the VACTERL association. Ped Surgery Int 21, 541–547 (2005). https://doi.org/10.1007/s00383-005-1452-3

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-005-1452-3

Keywords

Navigation