Evaluation of the Post-Pneumonectomy Space by Computed Tomography

Evaluation of chest computed tomography in patients after pneumonectomy to predict contralateral pneumothorax

“…Conversely, we surmise that hyperinfl ation of the residual lung may lead to contralateral pneumothorax. Several previous reports [9][10][11][12][13]16 have demonstrated changes in the cavity and in herniation of the residual lung after pneumonectomy. Christiansen and colleagues 13 reported that residual lung infl ation is not only increased but also the thoracic area of the removed part is gradually reduced after pneumonectomy.…”

“…9 After pneumonectomy, the airfi lled postpneumonectomy space is gradually replaced with serosanguineous fl uid as the air is absorbed, and the remaining lung expands across the midline. [9][10][11][12][13] As a result, the mediastinum and heart shift toward the surgical side. The return of the previously shifted mediastinum (particularly the tracheal air column) toward the midline is thought to be a useful radiographic sign of complications following pneumonectomy.…”

CT evaluation of empyema in the postpneumonectomy space

“…The normal appearance of the postpneumonectomy space includes hyperexpansion and hemiation of the contralateral lung, retraction of the postpneumonectomy space, and elevation of the hemidiagram on the operated side [3]. of the postpneumonectomy space is present on the chest radiograph, the sudden appearance of air-fluid levels can be the clue to the diagnosis [4].…”

“…Empyema, a rare complication of pneumonectomy, may occur within the postpneumonectomy space at any time postoperatively Evaluation of the postpneumonectomy space for empyema by conventional chest radiography may be difficult because of air-fluid levels [3]. If no air-fluid levels are present, complete opacification of the affected side may obscure an underlying abnormality.…”

“…Cornputed tomography (CT) has proven useful in evaluation of the postpneumonectomy space for recurrent disease, and the normal CT appearance of this space has been well described [3] (fig. 1A).…”