- Occurs after thoracotomy
- Torsion of the lung is defined as the parenchymal rotation of the whole lung on its bronchovascular pedicle
- Torsion of the lung can lead to obliteration of both blood supplies to the lung with resultant ischemia and eventual gangrene of the lung
- The ischemic lung is then associated with bronchorrhea, spillage of necrotic material into the opposite lung and alveolar hemorrhage
It is recommended that the severely ischemic lung should be removed, because detorsion of the affected lung can lead to an ischemia-reperfusion injury causing grave sequelae. Detorsion may lead to profound hemodynamic consequences, including hypoxemia, hypotension, severe acidosis, and showering of the brain with emboli from the pulmonary veins.
Torsion should be suspected whenever opacification of a hemithorax appears on chest radiographs after thoracotomies, as it did in this patient.
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