Zentralbl Chir 2021; 146(S 01): S60
DOI: 10.1055/s-0041-1733385
Abstracts

P-146 Symptomatic non-ischemic 90° lung torsion corrected 5 years after left upper lobectomy

W Essaleh
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S Welter
 
 

Hintergrund

Lung torsion is one of the rare postoperative complications following lung resections. Early clinical signs and symptoms are very nonspecific leading to delayed diagnosis and misdiagnosis in some cases (1), but ischemic necrosis necessitates removal of the remaining lung in many situations.


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Material und Methode

We present a rare case of 90° symptomatic non-ischemic left lower lobar torsion in a 61-year old female after left upper lobectomy for underlying lung adenocarcinoma. Her main complaints were severe repeated and exhausting dry cough attacks almost on a daily basis lasting for more than 5 minutes associated with dyspnea and cyanosis. The patient received a proper diagnosis almost 5 years after the initial surgery which was in Feb. 2016. During this period of time she was in and out of hospital due to her daily agony with severe repetitive dry cough attacks and breathlessness. The patient was treated with multiple endoscopic Stent-implantations it varied from Metal-stent in June 2016, a self-dissolving BD- Stent in 2017, a self-dissolving stent SX-ELLA in Jan. 2018 and a series of endoscopic Laser recanalizations of granulation tissue at the stent end as she was misdiagnosed with postoperative left lower lobe bronchus kink-stenosis.


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Ergebnis

An elective detorsion after extensive adhesiolysis was successfully undertaken in Feb 2021, after thorough radiological and functional evaluation. The postoperative period was complicated with prolonged air-leakage. The patient received several autologous blood pleurodesis and glucose pleurodesis. She was discharged on the 12th postoperative day in a good general condition and her dry cough was almost completely resolved at follow-up two weeks later.


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Schlussfolgerung

Lung lobar torsion should be considered as possible differential diagnosis in patients complaining of repetitive dry cough attacks after lung resection and necessitates interdisciplinary case discussion. Operative detorsion is the only causal therapy that should not be delayed.


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Publication History

Article published online:
06 September 2021

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