Postpneumonectomy Syndrome: A Rare Case of Indolent Airway Collapse

Postpneumonectomy syndrome (PPS) is a rare postoperative phenomenon characterized by dynamic airway obstruction and circulatory collapse resulting from excessive mediastinal shifting and rotation of critical structures. This paper presents a novel case of PPS manifesting approximately 3 decades after pneumonectomy in an acutely symptomatic 28-year-old man with clinical findings concerning for impending airway collapse. Cardiac computed tomography and pulmonary function testing were used as alternative, noninvasive means of monitoring for disease advancement. Approximately 113 incidences of PPS appear in the literature. Although a diagnosis of exclusion, it is important to consider the phenomenon given the life-threatening consequences. For this reason, virtually no powered data investigating the rate of disease regression has been published in the medical literature to date. Although space-occupying surgery serves as the most frequently used treatment modality, there remains no consensus on PPS management, patient selection, or timing of intervention among thoracic societies.