Rare Location and Drainage Pattern of Right Pulmonary Veins and Aberrant Right Upper Lobe Bronchial Branch: a Case Report

Abstract

BackgroundComplex aberration in lung is rare, which may increase risk of vascular injury and cause ligation of wrong pulmonary vein or bronchus by mistake during lung surgery, and result in sever complication like pulmonary congestion or atelectasis. Case presentationIn this case, a 44-year-old female was admitted for ground glass nodule (maximum diameter, 24mm) in right upper lobe. During operation, it was found that extremely rare aberrations of right preeparterial bronchus, right upper lobe vein behind pulmonary artery and right middle lobe vein drained into left atrium occurred in this patient simultaneously. Video-assisted thoracoscopic right upper lobectomy with lymph nodes dissection was performed for adenocarcinoma shown by frozen section. The patient was well recovered and discharged at the postoperative-day 4. Based on the literature review, such complex aberrations of pulmonary vessels and bronchus had seldom been reported before.ConclusionPreoperatively, three-dimensional reconstruction can help to identify inconspicuous variation of pulmonary vessels and bronchus effectively. During lung surgery, if anatomic aberration is suspected, careful dissection of vessels and bronchus will help to confirm whether there is an aberration or not.