A case of focal lung infarction following right upper lobectomy in case of undeveloped lung fissure

Abstract

We present a case of infarction of residual upper lobe tissue during right upper lobectomy. We believe that although the blood supply to the upper lobe had been isolated and divided in order to perform the right upper lobectomy, residual right upper lobe had been left behind secondary to "poorly estimated" staple separation of the upper from the middle lobe in a patient with non-developed oblique fissure. We suggest that in this situation the upper lobe bronchus should be identified and clamped and the lung re-inflated in order to accurately demarcate the borders of the upper and middle lobe prior to the application of the stapler to prevent infarction of residual upper lobe tissue. Therefore, this case emphasises that routine lung inflation during fissure development in right upper lobectomy may prevent unpredictable complications.