CTICasesPost-Pneumonectomy Syndrome Treated with Prosthetic Implants
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Imaging findings
Initial CT demonstrates severe rightward mediastinal shift, extreme hyperinflation of the left lung crossing the midline, and compression/narrowing of the left main bronchus and left lower lobe bronchus against the aorta, with a lack of fluid in the right pneumonectomy space. Post-operative radiographs and CT show correction of the mediastinal shift, midline tracheal positioning, widening of the left bronchi, and the presence of multiple silicone breast implants placed within the right pneumonectomy space.
Key takeaways
Post-pneumonectomy syndrome is a rare, late complication of pneumonectomy (more common on the right) characterized by extreme mediastinal shift and rotation, leading to mechanical compression of the remaining main bronchus against the aorta or spine. Surgical treatment involves returning the mediastinum to the midline, often achieved by filling the empty pneumonectomy space with non-absorbable saline- or silicone-filled prostheses (such as breast implants).
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