Tuberc Respir Dis.  2009 Mar;66(3):216-219. 10.4046/trd.2009.66.3.216.

A Case of Bronchial Obstruction Due to Bronchial Angulation after Upper Lobectomy

• Lee HS
• Yim JH
• Kim WJ
• Shin JH
• Oh YM

• KMID: 1846383
• DOI: http://doi.org/10.4046/trd.2009.66.3.216

Abstract

A bronchial obstruction of the remaining lung is a rare complication of thoracic surgery. We report a case of this rare complication after a right upper lobectomy due to a giant bulla. Post-resectional angulation of the bronchus intermedius caused the bronchial obstruction. An intrabronchial stent was inserted into the bronchus intermedius, which relieved the obstruction.

Keyword

Lobectomy; Obstruction; Stents

MeSH Terms

Blister
Bronchi
Lung
Stents
Thoracic Surgery

Figure

• 

  Figure 1 Bronchoscopic finding at the right bronchus intermedius. Pictures at the proximal portion of the bronchus intermedius (A) and at the site of the angulation (B) showed a near total obstruction of right bronchus intermedius.

• 

  Figure 2 Three dimensional CT of trachea and bronchi. Three dimensional CT scan showed a pin point narrowing at the distal bronchus intermedius.

• 

  Figure 3 Insertion of a metal stent. A bare metal stent (10 mm×3 cm) was inserted at the bronchus intermedius.

• 

  Figure 4 Bronchoscopic findings of the inserted metal stent. Pictures at the proximal portion of the bronchus intermedius (A) and at the site of the angulation (B) showed that the stent relieved the obstruction of right bronchus intermedius.

Reference

1. Van Leuven M, Clayman JA, Snow N. Bronchial obstruction after upper lobectomy: kinked bronchus relieved by stenting. Ann Thorac Surg. 1999. 68:235–237.

2. Korst RJ, Humphrey CB. Complete lobar collapse following pulmonary lobectomy: its incidence, predisposing factors, and clinical ramifications. Chest. 1997. 111:1285–1289.

3. Ferguson MK, Durkin AE. A comparison of three scoring systems for predicting complications after major lung resection. Eur J Cardiothorac Surg. 2003. 23:35–42.

4. Cable DG, Deschamps C, Allen MS, Miller DL, Nichols FC, Trastek VF, et al. Lobar torsion after pulmonary resection: presentation and outcome. J Thorac Cardiovasc Surg. 2001. 122:1091–1093.

5. Kanemitsu S, Tanaka K, Suzuki H, Tokui T, Kinoshita T. Pulmonary torsion following right upper lobectomy. Ann Thorac Cardiovasc Surg. 2006. 12:417–419.

6. Sundaramoorthi T, Hashim S, Dillon P, Ramachandra R, Collins FJ, Rosin MD. An unusual cause of breathlessness after lobectomy for lung cancer. Ann Thorac Surg. 2004. 78:e13–e14.