Omental flap in lung transplantation

Area of Science:

• Thoracic surgery
• Transplantation imaging
• Radiology

Background:

• Bronchial healing after lung transplantation is critical for patient outcomes.
• Omental wrapping of the bronchial anastomosis (omentopexy) is a surgical technique employed to potentially enhance healing.

Purpose of the Study:

• To describe the computed tomography (CT) appearance of intrathoracic omentum used in bronchial omentopexy.
• To determine the frequency and types of chest radiographic findings associated with the omental flap post-lung transplantation.

Main Methods:

• Retrospective review of chest radiographs and CT scans from 31 lung transplant recipients who underwent bronchial omentopexy.
• Analysis of the CT characteristics of the omental flap, including attenuation and vascularity.
• Correlation of radiographic findings with the presence and appearance of the omental flap.

Main Results:

• The omental flap was visualized on CT in all patients, typically with fatlike attenuation and linear opacities representing vessels.
• Chest radiographic findings corresponding to the omental flap were observed in 52% of patients (29 findings in 16 patients).
• No significant correlation was found between the surgical procedure type and the presence of radiographic findings related to the omentum.

Conclusions:

• The omental flap used in bronchial omentopexy can present a diagnostic challenge, potentially mimicking pathology on post-lung transplantation chest radiographs.
• Computed tomography (CT) is effective in identifying the omental flap due to its distinct attenuation characteristics and anatomical course, aiding in differential diagnosis.