Pulmonary artery aneurysm (PAA) is a rare entity. We report what we believe to be the first case of bronchiectasis resulting from a PAA, which in turn developed after a previous Senning procedure for transposition of the great vessels during infancy. The patient had bronchiectasis secondary to compression of the left main bronchus because of a PAA. Bronchiectasis is a condition indicating lung resection. Despite the patient receiving medical therapy to treat recurrent pneumonia, lobectomy was necessary to prevent this and other possible complications.
Symptoms will include expectoration of milky-white, foul-tasting sputum. However, the degree of production will be variable and not necessarily postprandial or linked with fatty food consumption. Lymphangiograms can aid in the diagnosis, although this is dependent on the speed of accumulation of the chyle leak. Where it is not available, radionuclide lymphoscintigraphy, normally reserved for imaging of malignant disease or lymphedema of the extremities, also can be used to visualize abnormalities of the thoracic duct. 4 CONCLUSIONS Iatrogenic injury to the thoracic duct is a not an uncommon consequence of thoracic cavity surgery. We present a case of such an injury after distal aortic arch repair, with persistent chylothorax and chyloptysis as a consequence. Although the preference of the original treating surgeon was to attempt surgical correction via redo thoracotomy, in this case right-assisted video-assisted thoracoscopy duct ligation was used as a successful conclusive treatment modality. Because video-assisted thoracic surgery has a relatively low morbidity and cost, earlier use of this approach is supported by the literature.
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