Imaging in postpneumonectomy complications: A pictorial review

Abstract

Pneumonectomy is done in patients with operable bronchogenic cancer and intractable end-stage lung diseases such as tuberculosis and bronchiectasis. It is often followed by postoperative complications with an incidence of 20-60%. Factors influencing the incidence and type of complication after lung resection include age, physical status, and procedure. Many of these complications are life threatening and require appropriate immediate management. Therefore, the knowledge of diverse radiologic appearances of these complications and familiarity with the clinical settings in which specific complications are likely to occur are vital for prompt and effective treatment. This pictorial review intends to educate the radiologists and clinicians regarding early detection of these complications.

Lung cancer: from screening to post-radical treatment

“…Air is gradually absorbed and after 1 week, fluid fills the space from bleeding, lymphatics and passive exudation. 89 Over the following 3 weeks to 7 months, there is increasing volume loss, ipsilateral mediastinal shift and contralateral lung hyperinflation. On CT, the post-pneumonectomy space is either fluid filled with fibrous margins or by fibrous tissue and mediastinal structures.…”

“…On CT, the post-pneumonectomy space is either fluid filled with fibrous margins or by fibrous tissue and mediastinal structures. 89 Rapid accumulation of fluid in the pneumonectomy space raises concern for haemothorax, chylothorax or infection. Mortality rates are high with empyema, particularly if associated with bronchopleural fistulae.…”