ABSTRACT
Infarction of the lung usually results from pulmonary arterial obstruction. Pulmonary infarcts often become infected from bronchial contamination and may become lung abscesses, empyema, or bronchopleural fistula causing sepsis. Diagnosis is important for intensive therapy, since infection is prone to spread. Resection of the infarcted lung should be considered early in an attempt to control infection. A sixty-seven-year-old man was hospitalized with dyspnea. A computed tomographic scan of the chest showed left lower lobe infiltration and mild pleural effusion with pleural thickening. There was a thrombus in the left pulmonary artery leading from the lower lobe to the upper lobe artery. At operation, the left lower lobe was found to have complete hemorrhagic infarction. The left lower lobectomy was performed. The remaining thrombus was removed after the left main pulmonary arteriotomy. He has been followed up for 15 months and has done well with no recurrence of thrombus and infarction of the lung.
Subject(s)
Arteries , Diagnosis , Dyspnea , Empyema , Fistula , Infarction , Lung , Lung Abscess , Pleural Effusion , Pulmonary Artery , Pulmonary Embolism , Pulmonary Infarction , Recurrence , Sepsis , Thorax , Thromboembolism , ThrombosisABSTRACT
An eight-year-old boy was referred to our hospital with cough and high fever. His past medical history included a small sized ventricular septal defect (VSD) at birth. Transthoracic echocardiography disclosed a 10x6 mm vegetation on tricuspid valve, a small VSD and the moderate tricuspid valve insufficiency were found. Blood cultures grew methicillin-resistant staphylococcus aureus. Despite proper antibiotic therapy, fever was not controlled and his course was complicated by pulmonary infarction. The patient simultaneously underwent pulmonary resection and open heart surgery. Through the median sternotomy we performed open thrombectomy and lobectomy (right lower lobe) at first, and then vegetectomy, tricuspid valve repair, and direct closure of VSD were done under cardiopulmonary bypass.
Subject(s)
Humans , Male , Cardiopulmonary Bypass , Cough , Echocardiography , Endocarditis , Fever , Heart Septal Defects, Ventricular , Heart , Hyperthermia, Induced , Methicillin-Resistant Staphylococcus aureus , Parturition , Pulmonary Infarction , Sternotomy , Thoracic Surgery , Thrombectomy , Tricuspid Valve Insufficiency , Tricuspid ValveABSTRACT
The remaining lung infarction is a rare but life-threatening complication after a thoracic operation and trauma. We report a case of this rare complication after the left upper lobectomy due to pulmonary aspergilloma. The infarction of the remaining left lower lobe occurred due to kinking of the pulmonary vessels after the left upper lobectomy and the completion pneumonectomy was performed in the post-operative second day. Therefore, prompt diagnosis and treatment may be necessary to prevent morbidity and mortality associated with pulmonary infarction from torsion of pulmonary artery and vein.
Subject(s)
Diagnosis , Infarction , Lung , Mortality , Pneumonectomy , Pulmonary Artery , Pulmonary Infarction , VeinsABSTRACT
Pulmonary infarction is rarely diagnosed with certainty except at postmortem examination. Part of this uncertainty is because of the inability to distinguish between hemorrhage, congestive a electasis, and necrosis clinically and radiographically. The pathogenesis of pulmonary infarction is poorly understood. It is dif%cult to induce pulmonary infarction in animals by ligation of the arterial supply to the lung. Many factors seem to be important in its pathogenesis, in addition to congestive heart failure, malignant tumor, thrombophlebitis, chronic obstructive lung disease, nephrotic syndrome, and postopeiative state. However, pulmonary infarction have not been reported in association with chest trauma. We report a case of pulmonary infarction associated with fractures of right clavicle and multiple ribs. A 45-year-old male had admitted due to right chest pain and dyspnea, which developed after right chest trauma occurred at about 3 weeks ago. He was treated at local clinics under the diagnosis of fractures of right clavicle and ribs until the admission. Chest CT disclosed a huge mass with central low density in right upper lobe, and small masses were also seen on both lung fields. Open lung biopsy resulted in negativity for the malignancy. Clinical symptoms and radiological findings were not improved by conservative treatment. Right upper lobectomy was done eventually. The final diagnosis was pulmonary infarction. And, the patient has been well after operation.