CTICasesAcquired Left Lower Lobe Bronchial Angulation and Recurrent Aspiration
Imaging findings
Initial CT in 2011 showed a normal left main stem bronchus. Subsequent imaging over multiple months/years after a stroke revealed progressive, severe posterior angulation and displacement of the left main stem bronchus, with unilateral bronchiectasis and volume loss in the left lower lobe. This angulation predisposed the patient to recurrent, severe left lower lobe aspiration events, with mediastinal rotation compensating for some of the volume loss.
Key takeaways
Significant changes in bronchial angulation and morphology, especially unilateral and progressive, can occur after events like stroke leading to chronic aspiration. This acquired anatomical alteration can create a dependent bronchus, perpetuating recurrent aspiration events. Mediastinal rotation can mask the full extent of associated lung volume loss.
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