Postpneumonectomy Syndrome

Postpneumonectomy syndrome is a rare condition that occurs in children or adults following a pneu-monectomy.28,29 For reasons that are not well understood, in certain patients, the heart and mediastinum shift excessively toward the side of the pneumonectomy and the great vessels rotate significantly. In the case

figure 4-11 Congenital tracheal stenosis. A, Coronal tomogram demonstrates diffuse stenosis of the intrathoracic trachea. B, Computed tomography image through the midtrachea reveals a complete cartilaginous tracheal ring and significant stenosis of the trachea (C). D,E, Following a slide tracheoplasty procedure, the tracheal lumen is significantly greater.

figure 4-11 Congenital tracheal stenosis. A, Coronal tomogram demonstrates diffuse stenosis of the intrathoracic trachea. B, Computed tomography image through the midtrachea reveals a complete cartilaginous tracheal ring and significant stenosis of the trachea (C). D,E, Following a slide tracheoplasty procedure, the tracheal lumen is significantly greater.

of a right pneumonectomy with a left-sided aortic arch, the remaining distal trachea and/or left main bronchus becomes interposed between the pulmonary artery anteriorly and the aorta and thoracic spine posteriorly, resulting in a stenosis of the distal trachea or main bronchus (Figure 4-12). A similar compli-

figure 4-12 Postpneumonectomy syndrome. Posteroanterior (A) and lateral (B) radiographs of the chest following a right pneu-monectomy reveal marked shift of the mediastinum and heart to the right and posteriorly. A contrast-enhanced chest computed tomography scan reveals counterclockwise rotation of the pulmonary artery (P) that is horizontal in orientation (C, D). The left main bronchus (arrow) is narrowed and interposed between the left main pulmonary artery (PA) anteriorly and the descending aorta (A) posteriorly (D, E).

cation may be seen following a left pneumonectomy with a right-sided aortic arch. Cross-sectional imaging with CT and/or MRI is essential to establish the vascular and bronchial relationships and to define the position and extent of the tracheobronchial obstruction. Inspiratory/expiratory CT imaging is useful to identify a malacic segment that may rarely occur at the level of the stenosis. Postoperative imaging following repositioning of the mediastinum helps to redefine the vascular and tracheobronchial positions and confirm establishment of a patent airway.

Was this article helpful?

0 0
Peripheral Neuropathy Natural Treatment Options

Peripheral Neuropathy Natural Treatment Options

This guide will help millions of people understand this condition so that they can take control of their lives and make informed decisions. The ebook covers information on a vast number of different types of neuropathy. In addition, it will be a useful resource for their families, caregivers, and health care providers.

Get My Free Ebook


Post a comment