Chest
Volume 99, Issue 6, June 1991, Pages 1515-1516
Journal home page for Chest

Selected Reports
Case Reports
Pulmonary Vein Thrombosis Following Bilobectomy

https://doi.org/10.1378/chest.99.6.1515Get rights and content

Acute thrombosis of the pulmonary vein following lobectomy or bilobectomy is a rare complication with no standard guideline for diagnosis or management. In this report, we present a case of right upper lobe vein thrombosis following a middle and lower lobectomy. Diagnosis was confirmed by ventilation-perfusion lung scan, pulmonary angiogram, and bronchoscopy. The patient was treated conservatively with no further complications and had a partial recovery of the circulation to the right upper lobe. A review of the literature is also presented along with the experimental data demonstrating the mechanisms of recovery.

Section snippets

Case Report

A 72-year-old man underwent an uneventful right lower and middle lobectomy at the Portland (OR) Veterans Affairs Medical Center, for a T2, NO, squamous cell carcinoma of the right lower lobe of the lung. The resected hilar nodes were found to have a previously undiagnosed chronic lymphocytic leukemia. The patient had undergone a redo coronary bypass graft one month prior to his lobectomy for symptomatic coronary artery disease. He also had a history of hypertension and an elevated absolute

Discussion

This is the second case, to our knowledge, being reported with the diagnosis of pulmonary vein thrombosis following a pulmonary resection. Interestingly, the case descriptions are almost identical. They both followed a right lower and middle lobectomy and both developed identical radiologic changes two days postoperatively.3

The two possible mechanisms of occluding the remaining superior pulmonary vein in our patient would have been a torsion-angulation or thrombosis. The normally aligned right

References (9)

There are more references available in the full text version of this article.

Cited by (27)

  • The appearance of a small thrombus in the pulmonary vein indicates the existence of a smaller pulmonary vein

    2015, IJC Heart and Vasculature
    Citation Excerpt :

    Pulmonary vein thrombosis is a potentially life threatening condition that can lead to thromboembolic stroke, but the occurrence of this type of thrombosis is believed to be rare and often goes undiagnosed and untreated. The primary causes of pulmonary vein thrombi formation are thought to be lung surgery [2], lung transplantation [3,4], and increased expansion of lung cancer [5]. The signs and symptoms of this condition are generally atypical, thus resulting in its underdiagnosis.

  • Pulmonary vein thrombosis associated with a large hiatal hernia

    2013, Journal of Emergency Medicine
    Citation Excerpt :

    No other epidemiologic or surgical factors were identified as risk factors for PVT after lung transplantation (7). PVT has occurred after other thoracic interventions, including bilobectomy and radiofrequency ablation (9,11). Several cases of PVT associated with lung cancer have been reported.

View all citing articles on Scopus
View full text