Scientific Letter
Bilateral Intralobar Pulmonary Sequestration in a Young Adult. A Case Report
Secuestro pulmonar intralobar bilateral en adulto joven. A propósito de un caso
Filomena Oliveri Aruete
, Ariela Candelario Cáceres, Enrique Alonso Mallo
Corresponding author
Servicio de Neumología, Hospital Río Carrión, Complejo Asistencial Universitario de Palencia, Palencia, Spain
Read
4094
Timeswas read the article
1516
Total PDF
2578
Total HTML
Share statistics
array:24 [ "pii" => "S1579212917300885" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.03.010" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "1463" "copyright" => "SEPAR" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:281-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1314 "formatos" => array:3 [ "EPUB" => 123 "HTML" => 846 "PDF" => 345 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0300289616302459" "issn" => "03002896" "doi" => "10.1016/j.arbres.2016.09.008" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "1463" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:281-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2190 "formatos" => array:3 [ "EPUB" => 105 "HTML" => 1597 "PDF" => 488 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científica</span>" "titulo" => "Secuestro pulmonar intralobar bilateral en adulto joven. A propósito de un caso" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "281" "paginaFinal" => "282" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Bilateral Intralobar Pulmonary Sequestration in a Young Adult. A Case Report" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1685 "Ancho" => 1500 "Tamanyo" => 385290 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Radiografía de tórax PA donde se observa una masa bien definida en LID, sin aparente broncograma aéreo en su interior, y una opacidad tubular retrocardiaca izquierda que corresponde a un vaso nutricio proveniente de una rama de la aorta abdominal. B-D) Reconstrucción de la TC de tórax donde se evidencian los vasos que nutren ambos secuestros. En el derecho se observa la arteria proveniente de la aorta abdominal con su drenaje venoso a aurícula izquierda, a través de la vena pulmonar inferior derecha. En el izquierdo se visualiza la arteria proveniente de la aorta torácica con su drenaje venoso a aurícula izquierda, a través de la vena pulmonar inferior izquierda.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Filomena Oliveri Aruete, Ariela Candelario Cáceres, Enrique Alonso Mallo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Filomena" "apellidos" => "Oliveri Aruete" ] 1 => array:2 [ "nombre" => "Ariela" "apellidos" => "Candelario Cáceres" ] 2 => array:2 [ "nombre" => "Enrique" "apellidos" => "Alonso Mallo" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212917300885" "doi" => "10.1016/j.arbr.2017.03.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917300885?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302459?idApp=UINPBA00003Z" "url" => "/03002896/0000005300000005/v1_201704280943/S0300289616302459/v1_201704280943/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1579212917300873" "issn" => "15792129" "doi" => "10.1016/j.arbr.2017.03.009" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "1462" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:282-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1637 "formatos" => array:3 [ "EPUB" => 134 "HTML" => 1145 "PDF" => 358 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Kikuchi-Fujimoto Disease as a Differential Diagnosis for Lymph Nodetuberculosis. The First Case of Kikuchi-Fujimoto Disease in Peru" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "282" "paginaFinal" => "284" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Enfermedad de Kikuchi-Fujimoto como diagnóstico diferencial de tuberculosis ganglionar. Reporte del primer caso de enfermedad de Kikuchi-Fujimoto en Perú" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2249 "Ancho" => 1500 "Tamanyo" => 1026636 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) BK negative; (B) PAS negative; (C) EBV negative; (D) CD3 partially positive; (E) CD15 negative; (F) CD20 partially positive; (G) CD30 positive in reactive lymphocytes and (H) CD68 positive for histiocytes.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jorge Nelson Chung-Ching" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Jorge Nelson" "apellidos" => "Chung-Ching" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616302447" "doi" => "10.1016/j.arbres.2016.09.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302447?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917300873?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000005/v1_201704280925/S1579212917300873/v1_201704280925/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212916303238" "issn" => "15792129" "doi" => "10.1016/j.arbr.2016.11.025" "estado" => "S300" "fechaPublicacion" => "2017-05-01" "aid" => "1477" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2017;53:279-80" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1065 "formatos" => array:3 [ "EPUB" => 133 "HTML" => 615 "PDF" => 317 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Tuberculosis Among Portuguese Living Abroad" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "279" "paginaFinal" => "280" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tuberculosis en los portugueses residentes en el extranjero" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Margarida Torres Redondo, Carlos Carvalho, Ana Maria Correia, Raquel Duarte" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Margarida Torres" "apellidos" => "Redondo" ] 1 => array:2 [ "nombre" => "Carlos" "apellidos" => "Carvalho" ] 2 => array:2 [ "nombre" => "Ana Maria" "apellidos" => "Correia" ] 3 => array:2 [ "nombre" => "Raquel" "apellidos" => "Duarte" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616302605" "doi" => "10.1016/j.arbres.2016.09.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616302605?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916303238?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000005/v1_201704280925/S1579212916303238/v1_201704280925/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Bilateral Intralobar Pulmonary Sequestration in a Young Adult. A Case Report" "tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "281" "paginaFinal" => "282" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Filomena Oliveri Aruete, Ariela Candelario Cáceres, Enrique Alonso Mallo" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Filomena" "apellidos" => "Oliveri Aruete" "email" => array:1 [ 0 => "Filomena.Oliveri@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Ariela" "apellidos" => "Candelario Cáceres" ] 2 => array:2 [ "nombre" => "Enrique" "apellidos" => "Alonso Mallo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neumología, Hospital Río Carrión, Complejo Asistencial Universitario de Palencia, Palencia, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Secuestro pulmonar intralobar bilateral en adulto joven. A propósito de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1685 "Ancho" => 1500 "Tamanyo" => 385290 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) PA chest radiograph showing a well-defined mass in the right lower lobe, containing no apparent air bronchogram, and left retrocardiac tubular opacity corresponding to a feeder vein originating from a branch of the abdominal aorta. (B–D) Reconstruction of chest CT showing vessels feeding both sequestrations. In the right side, the artery originating in the abdominal aorta can be seen with its venous drainage to the left atrium, via the right inferior pulmonary vein. In the left side, the artery originating in the thoracic aorta can be seen with its venous drainage to the left atrium, via the left inferior pulmonary vein.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 19-year-old man with a history of post-traumatic subdural hematoma in December 2014.</p><p id="par0010" class="elsevierStylePara elsevierViewall">He attended the emergency department of our hospital with a clinical picture suggestive of acute respiratory infection and radiological image consistent with right basal pneumonia. He denied any previous episodes of repeated catarrh or bloody expectoration.</p><p id="par0015" class="elsevierStylePara elsevierViewall">A chest radiograph performed during admission revealed a well-defined, homogeneous mass in the lower third of the right hemithorax, obliterating the hemidiaphragm, with no clear picture of air bronchogram in the interior. Given the homogeneous aspect of the mass, a chest CT was requested, also during admission, which described an area of lung consolidation 9<span class="elsevierStyleHsp" style=""></span>cm in diameter with peripheral bronchogram in the posterior and medial segment of the right lower lobe. Empirical antibiotic treatment began, and after good clinical progress and partial resolution of the radiological findings, the patient was discharged with a diagnosis of community-acquired pneumonia.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In a follow-up visit, partial persistence of the right homogeneous mass was noted, and a “tubular opacity” was observed in the left base behind the cardiac silhouette (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A), leading us to a diagnosis of pulmonary sequestration. An angiotomography was requested, which revealed pulmonary sequestration (PS) in the right lower lung base, with no fissure separating it from the rest of the pulmonary parenchyma, irrigated by an artery originating in the abdominal aorta, and venous drainage to the left atrium via the right inferior pulmonary vein; PS in the left posterior lung base, partial fissure separating it from the rest of the pulmonary parenchyma, irrigated by an artery originating in the thoracic artery, and venous drainage to the left atrium via the left lower pulmonary vein (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B–D).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">In view of the CT findings, the patient was referred to the reference thoracic surgery unit for surgical evaluation with a diagnosis of bilateral PS. Atypical ablation of the right lower lobe was performed by right video-assisted minithoracotomy with ligation of the artery originating in the abdominal aorta. In a second stage, 2 months later, atypical ablation of the left lower lobe was performed by left video-assisted minithoracotomy, with release of the sequestered artery and the inferior pulmonary vein. Intraoperative diagnoses were: right and left intralobar PS with accessory fissure in the left lower lobe, irrigated by a direct branch from the aorta. The pathology report described pulmonary parenchyma lined with visceral pleura, with isolated foci of pulmonary fibrosis and dilated bronchi, findings consistent with intralobar PS in the left lower lobe and right lower lobe.</p><p id="par0030" class="elsevierStylePara elsevierViewall">PS is a rare malformation, and diagnosis is generally made early in life. The treatment of choice is segmentectomy by thoracotomy. Most intralobar PS are unilateral, and bilateral PS are very rare. The general incidence of PS ranges between 0.15% and 1.8%; the exact statistics of bilateral PS have not yet been determined, but it is known to be extremely rare.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The radiological image of intralobar sequestration can vary: it can be a well-defined homogeneous mass, an air- or fluid-filled cystic lesion, a hyperlucent and hypovascular region, or a combination of all of these.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Presentation may also be unusual, as in our case, manifesting with only a subtle area of tubular opacity in the lower lobe that might represent the systemic vessels or venous drainage associated with the lesion.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Several case reviews published over the years have reported very few bilateral sequestrations, an example being the review published by Wei Y and Li F in 2011, in which only 3 of 2625 reviewed cases were bilateral; 2 patients both with intralobar PS, as in our case.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">With respect to treatment, surgical resection of the smallest amount of pulmonary parenchyma possible has been compared with angiographic embolization in newborns: the safest and most effective method appears to be surgical resection,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> although there have been reports of asymptomatic patients successfully treated with embolization.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Although many presentations of PS have been described in the literature, we must remember that slow-to-resolve pneumonias may conceal this entity, a fact that, along with the tubular opacity, guided us toward the diagnosis. Moreover, it is unclear how many cases of bilateral PS exist in Spain, and we believe that it would be of interest to make a larger case review study with the aim of furthering our knowledge of the topic.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Oliveri Aruete F, Candelario Cáceres A, Alonso Mallo E. Secuestro pulmonar intralobar bilateral en adulto joven. A propósito de un caso. Arch Bronconeumol. 2017;53:281–282.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1685 "Ancho" => 1500 "Tamanyo" => 385290 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) PA chest radiograph showing a well-defined mass in the right lower lobe, containing no apparent air bronchogram, and left retrocardiac tubular opacity corresponding to a feeder vein originating from a branch of the abdominal aorta. (B–D) Reconstruction of chest CT showing vessels feeding both sequestrations. In the right side, the artery originating in the abdominal aorta can be seen with its venous drainage to the left atrium, via the right inferior pulmonary vein. In the left side, the artery originating in the thoracic aorta can be seen with its venous drainage to the left atrium, via the left inferior pulmonary vein.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A rare case of bilateral pulmonary secuestration managed with embolization and surgical resection in a patient" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.P. Seok" 1 => "Y.J. Kim" 2 => "H.M. Cho" 3 => "H.Y. Ryu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5090/kjtcs.2013.46.6.475" "Revista" => array:6 [ "tituloSerie" => "Korean J Thorac Cardiovasc Surg" "fecha" => "2013" "volumen" => "46" "paginaInicial" => "475" "paginaFinal" => "477" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24368978" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lesiones broncopulmonares congénitas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W.R. Webb" 1 => "C.B. Higgins" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Radiología pulmonar y cardiovascular" "paginaInicial" => "21" "paginaFinal" => "27" "serieFecha" => "2009" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intralobar sequestration: radiologic–pathologic correlation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.A. Frazier" 1 => "M.L. Rosado de Christenson" 2 => "T. Stocker" 3 => "P.A. Templeton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Radiographics" "fecha" => "1997" "volumen" => "17" "paginaInicial" => "737" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary sequestration: a retrospective analysis of 2625 cases in China" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Y. Wei" 1 => "F. Li" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejcts.2011.01.080" "Revista" => array:6 [ "tituloSerie" => "Eur J Cardiothorac Surg" "fecha" => "2011" "volumen" => "40" "paginaInicial" => "e39" "paginaFinal" => "e42" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21459605" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Embolization versus surgical resection of pulmonary sequestration: clinical experiences with a thoracoscopic approach" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.J. Cho" 1 => "D.Y. Kim" 2 => "K.S. Kim" 3 => "E.A. Kim" 4 => "B.S. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpedsurg.2012.09.013" "Revista" => array:6 [ "tituloSerie" => "J Pediatr Surg" "fecha" => "2012" "volumen" => "47" "paginaInicial" => "2228" "paginaFinal" => "2233" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23217881" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000005/v1_201704280925/S1579212917300885/v1_201704280925/en/main.assets" "Apartado" => array:4 [ "identificador" => "49861" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000005/v1_201704280925/S1579212917300885/v1_201704280925/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917300885?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 3 | 10 |
| 2024 October | 41 | 16 | 57 |
| 2024 September | 41 | 13 | 54 |
| 2024 August | 69 | 37 | 106 |
| 2024 July | 44 | 24 | 68 |
| 2024 June | 53 | 25 | 78 |
| 2024 May | 70 | 31 | 101 |
| 2024 April | 48 | 25 | 73 |
| 2024 March | 59 | 18 | 77 |
| 2024 February | 42 | 26 | 68 |
| 2024 January | 0 | 1 | 1 |
| 2023 March | 12 | 2 | 14 |
| 2023 February | 49 | 24 | 73 |
| 2023 January | 31 | 27 | 58 |
| 2022 December | 51 | 28 | 79 |
| 2022 November | 54 | 32 | 86 |
| 2022 October | 32 | 30 | 62 |
| 2022 September | 40 | 20 | 60 |
| 2022 August | 36 | 38 | 74 |
| 2022 July | 42 | 47 | 89 |
| 2022 June | 40 | 25 | 65 |
| 2022 May | 37 | 32 | 69 |
| 2022 April | 29 | 42 | 71 |
| 2022 March | 27 | 34 | 61 |
| 2022 February | 33 | 24 | 57 |
| 2022 January | 39 | 35 | 74 |
| 2021 December | 33 | 39 | 72 |
| 2021 November | 37 | 43 | 80 |
| 2021 October | 39 | 45 | 84 |
| 2021 September | 30 | 43 | 73 |
| 2021 August | 22 | 33 | 55 |
| 2021 July | 17 | 20 | 37 |
| 2021 June | 30 | 24 | 54 |
| 2021 May | 36 | 34 | 70 |
| 2021 April | 84 | 52 | 136 |
| 2021 March | 49 | 17 | 66 |
| 2021 February | 31 | 21 | 52 |
| 2021 January | 20 | 12 | 32 |
| 2020 December | 24 | 15 | 39 |
| 2020 November | 22 | 14 | 36 |
| 2020 October | 46 | 16 | 62 |
| 2020 September | 13 | 7 | 20 |
| 2020 August | 32 | 13 | 45 |
| 2020 July | 22 | 20 | 42 |
| 2020 June | 30 | 9 | 39 |
| 2020 May | 26 | 7 | 33 |
| 2020 April | 21 | 13 | 34 |
| 2020 March | 30 | 7 | 37 |
| 2020 February | 25 | 18 | 43 |
| 2020 January | 36 | 16 | 52 |
| 2019 December | 38 | 14 | 52 |
| 2019 November | 34 | 27 | 61 |
| 2019 October | 21 | 7 | 28 |
| 2019 September | 35 | 7 | 42 |
| 2019 August | 30 | 13 | 43 |
| 2019 July | 24 | 12 | 36 |
| 2019 June | 35 | 10 | 45 |
| 2019 May | 32 | 21 | 53 |
| 2019 April | 44 | 37 | 81 |
| 2019 March | 33 | 16 | 49 |
| 2019 February | 21 | 18 | 39 |
| 2019 January | 20 | 10 | 30 |
| 2018 December | 15 | 15 | 30 |
| 2018 November | 41 | 11 | 52 |
| 2018 October | 63 | 22 | 85 |
| 2018 September | 24 | 7 | 31 |
| 2018 May | 20 | 0 | 20 |
| 2018 April | 16 | 7 | 23 |
| 2018 March | 13 | 2 | 15 |
| 2018 February | 28 | 13 | 41 |
| 2018 January | 64 | 4 | 68 |
| 2017 December | 66 | 7 | 73 |
| 2017 November | 27 | 13 | 40 |
| 2017 October | 14 | 7 | 21 |
| 2017 September | 22 | 8 | 30 |
| 2017 August | 17 | 11 | 28 |
Show all
