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Case Reports
. 2018 Sep;10(9):E690-E693.
doi: 10.21037/jtd.2018.08.53.

Case of spontaneous whole-lung torsion with literature review

Samuel F Ekstein, Amanda McCambridge, Eric S Edell, Chi Wan Koo, Shanda H Blackmon  1
Affiliations
Case Reports

Case of spontaneous whole-lung torsion with literature review

Samuel F Ekstein et al. J Thorac Dis. 2018 Sep.
No abstract available

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Thoracic Imaging of pulmonary torsion. (A) Axial chest CT revealed clockwise swirling around the right hilum with distortion of the bronchovascular bundle. Note moderate right pleural effusion. (B) Coronal images revealed inferomedial rotation of the collapsed right upper lobe with internal hypoattenuation representing a juxtadiaphragmatic abscess (arrow). (C) Anterior Tc-MAA perfusion image demonstrated markedly decreased right lung perfusion compared to the left. (D) Corresponding Xenon-133 ventilation scan showed right lung hypoventilation.
Figure 2
Figure 2
Bronchoscopy revealing pulmonary torsion. (A) Main carina with purulent material draining from the right mainstem; (B) distorted anatomy of the right lower lobe secondary to clockwise torsion; (C) right upper lobe take off, appearing extrinsically compressed, with purulent secretions.
Figure 3
Figure 3
Intraoperative anatomy. (A) Intraoperative anatomy after dissecting the pleura from hilum and untwisting the RUL. The RUL SPV is caudally displaced, while the azygous vein is displaced cranially. (B) The entire lung is rotated 180 degrees clockwise, as demonstrated by the RLL resting in the apex of the chest. LN, lymph node, RUL SPV, right upper lobe superior pulmonary vein; PA, pulmonary artery; SVC, superior vena cava; phrenic N, nerve; RLL, right lower lobe.
Figure 4
Figure 4
Right upper lobe after resection with significant abscess formation.
See this image and copyright information in PMC

References

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