Felmine V, Zuleika M
Department of Anaesthesia, St George's Hospital, Tooting, London, UK.
Anaesthesia. 2009 Oct;64(10):1130-3. doi: 10.1111/j.1365-2044.2009.05988.x.
Following thoraco-abdominal oesophagogastrectomy for an adenocarcinoma of the lower oesophagus, an 81-year-old female with no pre-existing respiratory disease could not be weaned from mechanical ventilation. Right upper and middle lobe torsion were found at thoracotomy on the 14th postoperative day. Both lobes were resected. The patient was discharged from hospital after several postoperative complications. Pulmonary torsion is a rare, potentially life-threatening complication of thoraco-abdominal oesophagogastrectomy. Differentiation from the more common postoesophagectomy pulmonary complications can be difficult. Early post-thoracotomy lung opacification, in the absence of the expected degree of hypoxaemia, should trigger a suspicion of pulmonary torsion.
一名81岁无基础呼吸系统疾病的女性，因下段食管癌接受胸腹段食管胃切除术后，无法撤机。术后第14天开胸手术时发现右上叶和中叶扭转。两叶均被切除。患者术后出现多种并发症后出院。肺扭转是胸腹段食管胃切除术罕见的、潜在危及生命的并发症。与更常见的食管切除术后肺部并发症进行鉴别可能很困难。开胸术后早期肺部出现不透明影，且无预期程度的低氧血症时，应怀疑肺扭转。
