CTICasesUnilateral Acute Respiratory Distress Syndrome (ARDS) due to Left Pulmonary Artery Agenesis
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Imaging findings
A patient presenting with ARDS exhibited unilateral consolidation (right lung) on serial chest x-rays over 7 days, with a relatively clear left lung, despite biopsy-proven ARDS. Subsequent imaging, including an outside study, confirmed agenesis of the left pulmonary artery and a right aortic arch with mirror-image branching.
Key takeaways
True unilateral ARDS is physiologically rare and suggests the absence of a capillary network in the unaffected lung. This case demonstrates that pulmonary artery agenesis can protect the affected lung from diffuse alveolar damage by preventing capillary leak, leading to unilateral ARDS when the contralateral lung is involved. Co-occurrence with a right aortic arch is also noted.
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