Pulmonary torsion of the lingula following a segmentectomy of the left upper division

Abstract

We report a case of pulmonary torsion of the lingula. Thoracoscopic segmentectomy of the left upper division was performed on a 67-year-old woman. The chest radiograph on the first postoperative day showed consolidation in the left apical area. By the second postoperative day, the consolidation had increased in size. Bronchoscopy and chest contrast-enhanced computed tomography (CT) were conducted, and she was diagnosed with torsion of the lingula. We performed an emergency operation and resected the affected lung because of a gangrenous lobe. Although pulmonary torsion is a rare complication following lung resection, thoracic surgeons should always consider the risk. To prevent pulmonary torsion, we should confirm the correct position of the remaining lobes, and fixation of the lobes should be performed if there is little or no parenchymal bridge between contiguous lobes. A high index of clinical suspicion is necessary for early diagnosis, and rethoracotomy should be performed without delay.