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Cardiothoracic Surgery: Fellow Case Report Slide: Cardiothoracic Surgery |

Lingular Torsion Presenting as Progressive Hypoxia

Svetlana Kotova, MD
Author and Funding Information

Providence Cancer Center, Portland, OR


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(4_S):44A. doi:10.1016/j.chest.2016.08.051
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SESSION TITLE: Fellow Case Report Slide: Cardiothoracic Surgery

SESSION TYPE: Affiliate Case Report Slide

PRESENTED ON: Wednesday, October 26, 2016 at 11:00 AM - 12:15 PM

INTRODUCTION: Pulmonary torsion after lung resection is rare (1-3). Only a few reports describe lingular torsion (2-3) after a segmentectomy and diagnosis is a challenge.

CASE PRESENTATION: 63 male, prior smoker but with excellent PFT’s, underwent bilateral thoracoscopy with wide excision on the right and a lingula sparing segmentectomy the left. Immediate postoperative course was complicated by subcutaneous emphysema. He developed dyspnea and required supplemental oxygen on day 3. CXR showed bilateral opacities. Despite diuresis, dyspnea and hypoxia worsened. Exam was showed stable subcutaneous crepitus and coarse breath sounds. Bilateral opacities progressed and non-contrast CT chest was obtained. Overall clinical picture of consolidation localized to lingula were worrisome for torsion. Bronchoscopy showed blood in the left main bronchus, and inability to enter lingular bronchus. Thoracoscopy showed congested and necrotic lingula and completion lobectomy was performed.

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