CTICasesPost-pneumonectomy Bronchomalacia
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Imaging findings
The patient underwent left pneumonectomy for a lung mass. Subsequent serial radiographs demonstrated poor expansion of the remaining lobe, with subcutaneous emphysema and minimal air identified in the distal left main bronchus. The bronchus appeared to collapse repeatedly, with no evidence of lung expansion on sequential imaging, despite attempted fixation of the lung to the chest wall. Surgical descriptions noted bronchomalacia, although the clinical presentation and persistent bronchial collapsibility were atypical.
Key takeaways
Post-pneumonectomy airway complications, such as bronchial torsion or severe bronchomalacia, should be considered when there is persistent, unexpected collapse of the remaining lung and failure of the bronchial tree to remain open. These cases can be challenging to differentiate from other causes of postoperative atelectasis and may require surgical intervention.
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