Torsion of the right middle and lower lobes following right upper lobectomy ; a case report

Abstract

Lung torsion is rare, and only a few cases have been reported in the medical literature. We describe a patient in whom lung torsion occurred following right upper lobectomy.
Our patient was a 58-year-old man who had a right upper lobectomy for bronchogenic carcinoma. On the first postoperative day, his chest radiograph showed atelectasis of the right middle lobe. Bronchoscopy revealed only an inflammatory change in the orifice of the right middle lobe. A plain chest radiograph, showed that the atelectatic lobe had not improved and position of the right lower lobe was abnormal. On the eight postoperative day, a reexplorative thoracotomy was performed. Adhesion of the mid mediastinum was present at S⁶, to be causing the residual lobes were twisted. The middle lobe was heavy and boggy with a blue-black hemorrhagic appearance. V⁴⁺⁵ was obstructed by thrombi, but A⁴⁺⁵ was patent. Middle lobectomy was performed and his postoperative course was good.