Childs Lucy, Ellis Steve, Francies Olivia
Royal London Hospital, Barts Health NHS Trust, London, UK.
BJR Case Rep. 2016 Jul 1;3(1):20160010. doi: 10.1259/bjrcr.20160010. eCollection 2017.
Lobar torsion is an uncommon phenomenon but a crucial diagnosis to consider in any patient undergoing lobectomy, as the clinical findings and radiographic appearances are non-specific. This case report documents the clinical and radiological evolution of middle lobe torsion in a patient who underwent right upper lobectomy for Stage 1 adenocarcinoma of the lung. The diagnosis of lobar torsion is most often made on CT scanning of the chest, which is frequently performed in order to distinguish this from multiple other more frequently encountered post-operative complications. Contrast-enhanced CT scan is the recommended imaging modality in suspected cases. If features of lobar torsion are identified, the findings must be communicated immediately to cardiothoracic surgeons owing to the potentially life-threatening consequences of delay. Management of lobar torsion is predominantly surgical, with several techniques currently in use; however, video-assisted thoracoscopic surgery is emerging as an increasingly favoured approach.
肺叶扭转是一种罕见的现象，但对于任何接受肺叶切除术的患者来说都是一个需要考虑的关键诊断，因为其临床表现和影像学表现不具有特异性。本病例报告记录了一名因I期肺腺癌接受右上肺叶切除术的患者中叶扭转的临床和影像学演变过程。肺叶扭转的诊断通常通过胸部CT扫描做出，胸部CT扫描经常进行是为了将其与其他更常见的术后并发症区分开来。对于疑似病例，推荐的成像方式是增强CT扫描。如果发现肺叶扭转的特征，由于延误可能会带来危及生命的后果，必须立即将结果告知心胸外科医生。肺叶扭转的治疗主要是手术治疗，目前有几种技术在使用；然而，电视辅助胸腔镜手术正日益成为一种更受青睐的方法。
