A case report of acute exacerbation of idiopathic pulmonary fibrosis after surgery for lung cancer

Abstract

A 63-year-old male was admitted because of an abnormal shadow on his chest x-ray. A transbronchial lung biopsy revealed squamous cell carcinoma and idiopathic pulmonary fibrosis. Mediastinoscopy, left upper lobectomy, partial resection of the left lower lobe and dissection of mediastinal lymph nodes were performed. On the 4th day after operation, PaO₂ was low and reticular shadows on chest x-ray were increased. Antibiotics and methylprednisolone (6g/day) were administered, but his condition did not improve, and he died on the 29th day after operation. Our experience indicates that when surgery is necessary for a patient with idiopathic pulmonary fibrosis, we must be very careful that the duration of the operation is short and the oxygen concentration must be less than 50% during the operation to prevent lung damage.