A congenital pulmonary malformation, such as
pulmonary sequestration or
congenital cystic adenomatoid malformation, should be suspected in infants with recurrent lower respiratory symptoms or unifocal infiltrations. The possibility of congenital pulmonary malformation associated with additional abnormalities, such as
diaphragmatic hernia, is relatively high and can lead to misdiagnosis. We report a case of a 6-month-old girl who presented with relapsing respiratory
infection and
hematemesis. Computerized axial tomography scan and
barium swallowing study were performed, revealing a suspected intralobar
pulmonary sequestration associated with sliding gastric
hernia. Since the patient's condition was complicated by sliding
hernia,
pneumonia and
pleural effusion, a
surgical procedure instead of cardiac catheterization with coil embolization was performed. During surgery, the absence of a sliding gastric
hernia but a
diaphragmatic eventration was noted. Only a partial portion of the left-side diaphragm was relaxing, making the
barium swallowing study difficult to interpret. This case serves as a reminder that if
pulmonary sequestration is suspected, a full work-up with a complete set of imaging studies should be ordered for the possible detection of associated gastrointestinal, respiratory and thoracic abnormalities.