You are here

Article Text

Article menu
Download PDFPDF
Case report
Postoperative cavitating infarction following lobectomy: the importance of variant pulmonary anatomy
  1. William John Hunter Brown1,
  2. Vidan Masani2,
  3. Tim Batchelor3 and
  4. Jonathan C L Rodrigues1
  1. 1Radiology Department, Royal United Hospital Bath NHS Trust, Bath, UK
  2. 2Respiratory Medicine, Royal United Hospital Bath NHS Trust, Bath, UK
  3. 3Thoracic Surgery, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
  1. Correspondence to Dr William John Hunter Brown; william.brown3{at}nhs.net

Abstract

A 75-year-old woman was admitted to hospital with haemoptysis, fever and shortness of breath. She had undergone a right video-assisted thoracoscopic surgery upper lobectomy for an apical lung cancer 4 weeks earlier, and had been treated with antibiotics for 1 week prior to admission for a suspected postoperative lung abscess. Review of preoperative imaging found that she possessed a lobar pulmonary artery variant, with postoperative imaging confirming that the right lower lobe segmental pulmonary artery had been divided alongside the upper lobe vessels. The diagnosis of a lung abscess was thus revised to a cavitating pulmonary infarct. There are numerous variations of the pulmonary vasculature, all of which have the potential to cause a range of serious vascular complications if not appreciated preoperatively. Measures to mitigate the risk of complications resulting from vascular anomalies should be considered by both radiologists and surgeons, with effective lines of communication essential to safe working.

  • radiology
  • cardiothoracic surgery

https://doi.org/10.1136/bcr-2020-238138

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Twitter @JCLRodrigues

    • Contributors The authors contributed to the Case Report as follows: WJHB: (1) Gathered all clinical and radiological data; (2) drafted and revised the article; (3) gives final approval of the version to be published; (4) agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. VM: (1) Looked after the patient in the postoperative period; (2) revised the article critically; (3) gives final approval of the version to be published; (4) agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. TB: (1) Looked after the patient in the postoperative period; (2) revised the the article critically; (3) gives final approval of the version to be published; (4) agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. JR: (1) Conception and supervision of the case report; (2) revised the article critically; (3) gives final approval of the version to be published; (4) agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.