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Pulmonary torsion after resuscitative thoracotomy: a case report
Daisuke Hara1, Tomoka Hamahiro1, Ryo Maeda1
1Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan.
Journal of Surgical Case Reports
|July 22, 2021
Summary
Pulmonary torsion is a rare complication following chest surgery. This case highlights delayed diagnosis after resuscitative thoracotomy in a trauma patient.
Area of Science:
- Thoracic Surgery
- Surgical Complications
- Medical Case Reports
Background:
- Pulmonary torsion is a rare but serious complication where the lung twists on its vascular pedicle.
- It can lead to lung ischemia and infarction, necessitating prompt diagnosis and intervention.
- Non-pulmonary thoracotomy, particularly resuscitative thoracotomy, presents unique challenges in postoperative monitoring.
Observation:
- A 38-year-old female patient sustained self-inflicted sharp force trauma to the chest and abdomen.
- Emergent abdominal surgery included a left-sided resuscitative thoracostomy due to hemorrhagic shock.
- Postoperative imaging revealed an abnormal shadow, but pulmonary torsion was not immediately suspected.
Findings:
- The diagnosis of pulmonary torsion was delayed by seven days despite initial imaging findings.
- The patient ultimately required a left upper lobectomy for management of the pulmonary torsion.
- This represents the first reported case of pulmonary torsion occurring after resuscitative thoracotomy.
Implications:
- This case underscores the importance of considering rare complications like pulmonary torsion in postoperative patients, even after non-pulmonary thoracic procedures.
- Enhanced vigilance and prompt diagnostic workup are crucial for timely intervention in such scenarios.
- Further research may be needed to elucidate the specific risk factors and optimal management strategies for pulmonary torsion following resuscitative thoracotomy.
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