Total pulmonary torsion without vascular compromise--a case report

Area of Science:

• Medicine
• Pulmonology
• Radiology

Background:

• Pulmonary torsion is an extremely rare condition with a high mortality rate.
• Previous cases have typically required surgical intervention or resulted in fatality.
• The etiology of pulmonary torsion is often unclear, but iatrogenic causes are possible.

Observation:

• A case of pulmonary torsion occurred secondary to a small right-sided pneumothorax after diagnostic transthoracic puncture.
• The patient presented with minimal acute clinical symptoms.
• Diagnostic evaluations included fibroscopy, isotopic perfusion scanning, and pulmonary angiography.

Findings:

• Pulmonary angiography revealed no compromise in pulmonary blood flow.
• Venous pulmonary return was preserved, despite the torsion.
• The patient demonstrated unexpectedly favorable clinical progress over a ten-month follow-up period.

Implications:

• This case suggests that pulmonary torsion may not always necessitate immediate surgical treatment.
• Preservation of pulmonary circulation is a key factor in determining patient outcomes.
• Further research into non-surgical management strategies for pulmonary torsion is warranted.