CTICasesIatrogenic Pulmonary Vein Ligation
Imaging findings
Non-contrast chest CT shows volume loss and mediastinal rotation on the left, with septal thickening and tortuous systemic collateral vessels along the pleura. Contrast-enhanced CT and perfusion scan confirm complete occlusion and absent flow in the left inferior pulmonary vein, with virtually no perfusion to the left lung. Suture material is noted near the left inferior pulmonary vein from a prior left upper lobectomy.
Key takeaways
Ligation of a pulmonary vein is a rare iatrogenic complication of lobectomy. It can present decades later with progressive dyspnea and pulmonary hypertension. CT findings include asymmetric chronic interstitial edema, septal thickening, and systemic arterial collaterals.
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