CTICasesLeft upper lobe torsion following aortic surgery
Imaging findings
CTA demonstrates 180-degree clockwise torsion of the left upper lobe with occlusion of the left upper lobe pulmonary artery, left superior pulmonary vein, and bronchus, resulting in severe parenchymal congestion, edema, and subsequent pulmonary gangrene/infarction. The left lower lobe remained in normal position.
Key takeaways
Pulmonary lobar torsion is a rare but life-threatening surgical complication following thoracic procedures where the lung is mobilized or the pulmonary ligament is ligated. The presence of a complete major fissure increases the mobility of individual lobes, predisposing them to torsion. Prompt re-intervention is critical to prevent or manage pulmonary infarction.
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