Drains and Blushes: A Case of Impaired Venous Drainage Mimicking Pulmonary Torsion

Abstract

A 47-year-old woman underwent elective right upper lobectomy with pneumopexy for adenocarcinoma. On postoperative day 2, she had tachycardia, and her chest radiograph, bronchoscopy, and computed tomography chest scan were suspicious for pulmonary torsion. She underwent emergent thoracotomy, and the right middle lobe was not torsed; it was purple, engorged, and not ventilated. The patient did well after right middle lobectomy. We suspect compromised middle lobe pulmonary venous drainage due to angulation after compensatory expansion. This uncommon phenomenon has not been described previously. High suspicion for pulmonary torsion and treatment led to avoidance of complications such as infection, gangrene, infarction, thromboembolism, and death.