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Pathologic consequences of bilateral pulmonary lower lobectomies: case report
R Cachecho1, F F Isik, E F Hirsch
1Department of Surgery, Boston University School of Medicine, Massachusetts.
The Journal of Trauma
|February 1, 1992
Summary
Most lung injuries heal without surgery. This case highlights that extensive lung resection for trauma, like bilateral lower lobectomies, can cause severe heart complications and high mortality, supporting conservative management.
Area of Science:
- Thoracic Surgery
- Trauma Management
- Cardiopulmonary Physiology
Background:
- Lung injuries are typically managed nonoperatively.
- Pulmonary resection is rarely indicated in thoracic trauma.
- Hilar injuries present unique management challenges.
Observation:
- A rare case of bilateral hilar injuries necessitated bilateral pulmonary lower lobectomies.
- The patient developed significant cardiopulmonary complications post-resection.
Findings:
- Extensive pulmonary resection in thoracic trauma leads to high mortality.
- Post-resection complications include pulmonary hypertension, right ventricular failure, and cardiogenic shock.
Implications:
- The findings underscore the risks associated with extensive pulmonary resection in trauma.
- A conservative, nonoperative approach is recommended for most lung injuries.
- Understanding cardiopulmonary sequelae is crucial for managing severe thoracic trauma.