Departmental Bulletin Paper Surgical resection of a pulmonary artery pseudoaneurysm after middle lobectomy: Report of a case

Miyazaki, Takuro  ,  Yamasaki, Naoya  ,  Tsuchiya, Tomoshi  ,  Matsumoto, Keitaro  ,  Shimoyama, Koichiro  ,  Taniguchi, Daisuke  ,  Kinoshita, Naoe  ,  Nagayasu, Takeshi

60 ( 1 )  , pp.25 - 27 , 2015-07 , Nagasaki University School of Medicine
A case of surgical resection of a pulmonary artery pseudoaneurysm after middle lobectomy is reported. A 76-year-old man with lung cancer, interstitial pulmonary fibrosis, and pneumoconiosis was referred for surgical resection. Right middle lobectomy with lymph node dissection was successfully performed. Postoperatively, the patient did well until a sudden high fever developed on postoperative day eight. Antibiotic therapy was started for suspected acute pneumonia, but the low-grade fever did not improve. Contrast-enhanced computed tomography showed a bronchopleural fistula that caused a pulmonary artery pseudoaneurysm. Right lower lobectomy via posterolateral thoracotomy was performed to resect the pseudoaneurysm. The pulmonary artery stump was sutured by monofilament unabsorbable stiches. The bronchus stump was sutured interruptedly with a pedicle of intercostal muscles. The patient’s postoperative course following repeat thoracotomy was complicated, including exacerbation of interstitial pneumonia and tracheostomy. He is still in hospital, and weaning off the mechanical ventilator is being attempted.

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