CTICasesIatrogenic Pulmonary Infarction after Metastasectomy
Imaging findings
Sequential chest radiographs and CT following right lower lobe metastasectomy for colorectal cancer demonstrate progressive consolidation in the right lower lobe. CT shows absent pulmonary artery opacification distal to the staple line, without venous enhancement, consistent with arterial ligation. Follow-up CT three months later shows residual areas of cavitation and parenchymal consolidation compatible with pulmonary infarction.
Key takeaways
Pulmonary resection via wedge stapling for central or deeply located metastases carries a risk of inadvertently stapling or ligating a pulmonary artery branch, resulting in segmental/lobar ischemia and infarction. CT pulmonary angiography can confirm the diagnosis by showing abrupt cutoff of arterial enhancement at the staple line with absence of distal perfusion.
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