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Case Reports
. 2020 Nov-Dec;37(6):530-532.
doi: 10.4103/lungindia.lungindia_254_19.

Successful video-assisted thoracoscopic management of the right middle lobe torsion: A rare complication of right upper lobectomy - A report of two cases

Mohan Venkatesh Pulle  1 , Belal Bin Asaf  1 , Harsh Vardhan Puri  1 , Arvind Kumar  1
Affiliations
Case Reports

Successful video-assisted thoracoscopic management of the right middle lobe torsion: A rare complication of right upper lobectomy - A report of two cases

Mohan Venkatesh Pulle et al. Lung India. 2020 Nov-Dec.

Abstract

Middle lobe torsion is an uncommon complication after right upper lobectomy. Clinical features are non-specific. CECT chest and diagnostic bronchoscopy are the essential investigations for the diagnosis. The treatment of choice is urgent re-exploration with either lobectomy or de-rotation with pneumopexy through thoracotomy or video assisted thoracoscopic approach based on the viability of lobe. Strong clinical suspiscion and early surgical intervention are the key points for success. This report highlights the role of video assisted thoracoscopic approach in the management of this rare complication.

Keywords: Middle lobe torsion; right upper lobectomy; video-assisted thoracoscopic surgery.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Right upper zone opacification suggestive of middle lobe torsion
Figure 2
Figure 2
Computed tomography chest showing middle lobe torsion
Figure 3
Figure 3
Chest X-ray suggestive of middle lobe torsion. Note wellexpanded right middle lobe after derotation
Figure 4
Figure 4
Intraoperative pictures of video assisted thoracoscopic surgery derotation and pneumopexy
See this image and copyright information in PMC

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