Torsion of right middle lobe after a right upper lobectomy

Abstract

Lobar torsion after lung resection is a quite rare complication. A 50-year-old woman presented typical features on chest radiographs and CT(computed tomography) scan of lobar torsion after a right upper lobectomy. After emergency lobectomy of right middle lobe, the patient recovered well and discharged 10 days after the second operation.

Successful video-assisted thoracoscopic management of the right middle lobe torsion: A rare complication of right upper lobectomy – A report of two cases

“…[ 4 ] Bronchoscopy shows bronchial occlusion with unusual orientation. [ 6 ] Infection, postoperative lobar atelectasis, aspiration pneumonia, and necrotizing pneumonia contribute to the close differential diagnoses. However, lobar torsion can be diagnosed by characteristic CECT and bronchoscopy findings, which does not fit any of these differentials.…”

Postoperative complications after thoracic surgery for lung cancer

“…Other possible changes within the torsed lobe include consolidation with an increase in volume, ground-glass changes, and inter-and intralobular septal thickening [16]. A bulging neofissure can be seen in lung torsion after lobectomy and poor or absent parenchymal enhancement may be noted on CT [29]. Torsion more often occurs in the milieu of easily displaceable pleural air and/or fluid [31].…”

“…Torsion occurs when a lobe, or the complete lung, rotates 180 degrees around hilar structures, although instances of 90 degree and 360 degree torsion have been described [16]. Lobar torsion most commonly involves the right middle lobe after right upper lobectomy or the lingula following a lingular sparing left upper lobectomy [28,29]. The torsed lung compromises the airways, arterial blood supply and lymphatic and venous drainage, resulting in hemorrhagic infarction or necrosis in the affected lobe(s) [30].…”

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

“…Pulmonary torsion is a rare but life-threatening complication most often seen in the right middle lobe after right upper lobe resection [1][2][3][4]. It is due to the parenchymal rotation of the lobe on the bronchovascular pedicle [5].…”