CTICasesPulmonary Torsion
Imaging findings
Chest CT in a patient post-right upper and lower lobectomy demonstrates a severely edematous, consolidated right middle lobe that has rotated 180 degrees. The pulmonary veins and bronchus supplying the middle lobe are completely occluded and pinched off, with the middle lobe arteries and bronchi coursing in an abnormal anterior-to-posterior direction.
Key takeaways
Pulmonary torsion is a rare, life-threatening iatrogenic complication following partial lung resection (typically lobectomy), where the remaining lobe rotates around its hilar pedicle. This leads to complete venous occlusion, hemorrhagic infarction, and gangrene. Key CT signs include bronchial and vascular tapering, abnormal vascular direction, and a consolidated, edematous lobe, requiring urgent completion pneumonectomy.
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