Abstract
A case of surgical resection of a pulmonary artery pseudoaneurysm after middle lobectomy is reported. A 76-year-old man
with lung cancer, interstitial pulmonary fibrosis, and pneumoconiosis was referred for surgical resection. Right middle lobectomy
with lymph node dissection was successfully performed. Postoperatively, the patient did well until a sudden high fever developed
on postoperative day eight. Antibiotic therapy was started for suspected acute pneumonia, but the low-grade fever did not improve.
Contrast-enhanced computed tomography showed a bronchopleural fistula that caused a pulmonary artery pseudoaneurysm.
Right lower lobectomy via posterolateral thoracotomy was performed to resect the pseudoaneurysm. The pulmonary artery
stump was sutured by monofilament unabsorbable stiches. The bronchus stump was sutured interruptedly with a pedicle of
intercostal muscles. The patient’s postoperative course following repeat thoracotomy was complicated, including exacerbation
of interstitial pneumonia and tracheostomy. He is still in hospital, and weaning off the mechanical ventilator is being attempted.
