Detorsion of the Pulmonary Torsion: A Rare Post-thoracotomy Complication

• Published in: Heart, lung & circulation Vol. 25; no. 3; pp. e62 - e63
• Main Authors: Wang, Xiaolong, MD, Chen, Xintao, MD, Ding, Zhidan, MD, Li, Yin, MD, PhD, Qin, Jianjun, MD,PhD
• Format: Journal Article
• Language: English
• Published: Australia Elsevier B.V 01.03.2016
• Subjects: Cardiovascular; Complication; Female; Humans; Lung - diagnostic imaging; Lung Diseases - diagnostic imaging; Lung Diseases - etiology; Mediastinal tumour; Middle Aged; Postoperative Complications - diagnostic imaging; Pulmonary torsion; Thoracotomy; Thoracotomy - adverse effects; Tomography, X-Ray Computed; Torsion Abnormality - diagnostic imaging; Torsion Abnormality - etiology; Pulmonary torsion; Complication; Mediastinal tumour; Thoracotomy
• ISSN: 1443-9506; 1444-2892
• DOI: 10.1016/j.hlc.2015.10.011

Pulmonary torsion is a rare but serious condition. Without prompt treatment it progresses to lobar ischaemia, pulmonary infarction and finally fatal gangrene. We present a case of this rare complication in a 61-year-old woman following thoracic operation without involving any lung resection. Careful post-operative clinical observation, chest X-ray and CT scans are crucial for precise diagnosis of lobar torsion. The bedside radiograph provided initial evidence of torsion. Computed tomography scans revealed the presumptive diagnosis of right upper lobe torsion. On exploration, a 70° rotation of the right upper lobe in a clockwise direction was found. The lobar torsion was carefully relieved, and lobar fixation was performed as a prophylaxis against recurrence of this complication. The post-operative period was uneventful. Early recognition and prompt intervention is imperative in order to save the affected lung. Patients with well-developed interlobar fissures may benefit from pulmonary lobe fixation.