Embolia pulmonar grave em pulmäo único / Severe pulmonary embolism in a single lung

RESUMO

Homem de 68 anos de idade, brnaco, com história de expectoraçäo acompanhada de laivos de sangue há 2 meses e com antecedente de tabagismo, apresentou imagem paracardíaca direita de aproximadamente 5 cm de diâmetro, em exame radiológico de tórax confirmado à tomografia. Endoscopia com biópsia identificou adenocarcinoma de lobo médio. Toracotomia permitiu encontrar tumor de lobo médio invadindo os outros lobos e pericárdio, procedendo-se à pneumectomia direita. No 10§ dia de pós-operatório, ocorreu tromboembolismo pulmonar, tendo mapeamento pulmonar mostrado hipoperfusäo de extensa área do pulmäo esquerdo; tratado imediatamente, teve boa evoluçäo, recebendo alta hospitalar no 22§ dia de pós-operatório. A embolia pulmonar tem maior gravidade quando em pulmäo único; porém, com rápido diagnóstico e tratamento, a evoluçäo foi favorável

ABSTRACT

A 68 years old white man complaining of hemoptysis in the last 2 months was ad misted for evaluation. He was a heavy smoker and thorax radiography as week as CT Scan shonwed a 5 cm mass in the right pulmonary hilum. Endoscopy with biopsy demonstrated an adenocarcinoma of middle lobe. He was operated on and a tumor was found in the middle lobe with invasion of the other two lobes and pericardium. A right pneumectomy was performed. In the 10 th postoperative day the patient sustained a pulmonary thromboembolism. A pulmonary scintigraphy showed hypoperfusion of large areas of left lung. He was medically treated and had a good response. The patient was discharged in the 22 nd postoperative day. Pulmonary thrombembolism in bowen more severe in patients with single lung, nevertheless the recovery of this patients was good with early diagnosis and treatment.