Acute bilateral renal infarction after left upper pulmonary lobectomy: a case report

Left upper lobectomy (LUL) is considered a risk factor for thrombus formation in the pulmonary vein stump compared with other lobectomies, and it occurs in 11.7-13.5% of cases. Although cerebral infarction after LUL has been reported in many articles, reports of bilateral renal infarction after lobectomy are rare.

A 70-year-old male patient was admitted to our hospital with a diagnosis of lung cancer. The nodule's diameter was 2.5 cm on computed tomography, and it was diagnosed as a non-small cell lung carcinoma by a bronchoscopic biopsy. The clinical stage was cT1c N0M0 (c-stageIA3). The patient underwent thoracoscopic LUL and systemic lymph node dissection. No complications were observed during the operation, and the immediate postoperative period was uneventful until postoperative day 3. On postoperative day 4, he experienced fever, abdominal pain, and nausea, which spontaneously resolved. Laboratory data showed an elevated white blood cell count, and elevated serum lactate dehydrogenase and creatinine concentrations. Contrast-enhanced computed tomography from the thorax to the pelvic cavity showed a partial defect of the bilateral kidneys. We diagnosed the patient with bilateral renal infarction.

Bilateral renal infarction after lobectomy is a rare and serious condition, which should be diagnosed as early as possible. Since all cases of reported renal infarctions occurred after LUL, special attention should be paid to postoperative management after performing LUL.