A case of lung torsion of the lingula after segmentectomy of the upper division of the left lung

Abstract

We report a case of lung torsion (LT) of the lingula following segmentectomy of the upper division of the left lung. A 67-year-old man underwent segmentectomy of the upper division of the left lung for primary left upper lobe lung cancer (cT1bN0M0, Stage IA2). Blood sputum appeared on the second postoperative day. We suspected LT of the lingula and performed bronchoscopy and chest enhanced computed tomography (CT). Bronchoscopy did not reveal occlusion of B⁴⁺⁵ but enhanced CT showed interruption of V⁴⁺⁵. We diagnosed the patient with LT of the lingula and decided to perform an emergency operation. The lingular segment showed congestion and swelling; therefore, we performed lingulectomy. The patient was discharged on postoperative day twelve. Since the pathological diagnosis was hemorrhagic infarction, it did not contradict LT. LT is defined as rotation of the bronchovascular pedicle with resultant airway obstruction and vascular compromise. Effective examinations for evaluating bronchi and vessels are different. It is considered that early diagnosis and treatment by bronchoscopy and enhanced CT are important because LT can sometimes be a serious complication.