CTICasesIntercostal Muscle Flap for Bronchial Stump Reinforcement Post-Pneumonectomy
Imaging findings
Chest radiographs demonstrate a rounded, soft-tissue opacity near the hilum following a left pneumonectomy. On CT, this correlates with a small, low-attenuation structure located within the fluid-filled post-pneumonectomy space, representing an intercostal muscle flap wrapped with extrapleural fat.
Key takeaways
Thoracic surgeons frequently mobilize an intercostal muscle flap to reinforce the bronchial stump after a pneumonectomy to prevent bronchopleural fistula formation. On subsequent radiographs and chest CT, the flap (along with some extrapleural fat) can appear as a rounded mass-like structure in the post-pneumonectomy space, which should not be confused with tumor recurrence, abscess, or hematoma.
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