Abstract
We report a case of postoperative lung torsion, a relatively rare but serious complication of lung surgery. A 52-year-old male patient was diagnosed with adenocarcinoma (T2N1M0 c-stage IIB) via transbronchial lung biopsy, and underwent left upper lobectomy and mediastinal lymphadenectomy. On chest X-ray, decreased transparency was noted in the left lung field from postoperative day 1. The patient developed fever and abnormally elevated levels of inflammatory markers on postoperative day 3. Bronchoscopic examinations revealed stenosis in the left lower lobe bronchus, and torsion of the remaining lower lobe was suspected. Therefore, rethoracotomy was performed. The lung was found to be swollen and dark red, and had twisted approximately 180 degrees around a bronchial tube. The remaining lobe was removed. The patient underwent postoperative respiratory rehabilitation and was discharged from hospital on postoperative day 20, having made satisfactory progress. The likely causes of the lung torsion included division of the pulmonary ligament, failure to take into account the suture direction during bronchial separation when carrying out automated suturing, and failure to check the position of the remaining lobe at the time of closing the chest.
