scholarly journals Right apical-posterior segmentectomy with abnormal anterior segmental bronchus and artery: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xining Zhang ◽  
Gang Lin ◽  
Jian Li
Keyword(s):  
Postoperative Complications ◽  
Pulmonary Artery ◽  
Structural Variation ◽  
Middle Lobe ◽  
Lobe Bronchus ◽  
Case Presentation ◽  
3 Dimensional ◽  
Computed Tomographic ◽  
Segmental Bronchus ◽  
Artery Branch

Abstract Background Displaced anterior segmental bronchus and pulmonary artery is extremely rare. A keen knowledge of such variations is required in the field of pulmonary segmentectomy, for unawareness of the structural variation could lead to intra- and postoperative complications. Case presentation A 50-year-old female presented to our department with suspected lung adenocarcinoma. Preoperative 3-dimensional computed tomographic bronchography and angiography revealed anterior segmental bronchus and anterior segmental pulmonary artery variation: the anterior segmental bronchus derived from the middle lobe bronchus, accompanied by a distally distributed anterior segmental pulmonary artery branch. A right apical-posterior segmentectomy using inflation-deflation technique was performed successfully. Conclusions The keen observation and proper application of modern imaging technology and operative technique could greatly aid segmentectomy, preventing intra- and postoperative complications from happening.

scholarly journals Right Apical-Posterior Segmentectomy with Abnormal Anterior Segmental Bronchus and Artery: A Case Report

2020 ◽  
Author(s):  
Xining Zhang ◽  
Gang Lin ◽  
Jian Li
Keyword(s):  
Postoperative Complications ◽  
Pulmonary Artery ◽  
Structural Variation ◽  
Middle Lobe ◽  
Lobe Bronchus ◽  
Case Presentation ◽  
3 Dimensional ◽  
Computed Tomographic ◽  
Segmental Bronchus ◽  
Artery Branch

Abstract Background: Displaced anterior segmental bronchus and pulmonary artery is extremely rare. A keen knowledge of such variations is required in the field of pulmonary segmentectomy, for unawareness of the structural variation could lead to intra- and postoperative complications. Case presentation: A 50-year-old female presented to our department with suspected lung adenocarcinoma. Preoperative 3-dimensional computed tomographic bronchography and angiography revealed anterior segmental bronchus and anterior segmental pulmonary artery variation: the anterior segmental bronchus derived from the middle lobe bronchus, accompanied by a distally distributed anterior segmental pulmonary artery branch. A right apical-posterior segmentectomy was performed successfully. Conclusions: The keen observation and proper application of modern imaging technology and operative technique could greatly aid segmentectomy, preventing intra- and postoperative complications from happening.

Injury to the Middle Lobe Bronchus and Pulmonary Artery: An Unusual Pattern

1983 ◽  
Vol 35 (2) ◽  
pp. 156-158 ◽  
Author(s):  
A. Zapolanski ◽  
R. Ilves ◽  
T.R.J. Todd
Keyword(s):  
Pulmonary Artery ◽  
Middle Lobe ◽  
Lobe Bronchus ◽  
Unusual Pattern

scholarly journals Foreign body extraction through the rigid bronchoscopy

2011 ◽  
Vol 68 (10) ◽  
pp. 878-880 ◽  
Author(s):  
Stanko Mrvic ◽  
Milos Milosavljevic ◽  
Dragan Stojkovic ◽  
Slobodan Milisavljevic ◽  
Dragce Radovanovic ◽  
...  
Keyword(s):  
Foreign Body ◽  
Pediatric Population ◽  
Tracheobronchial Tree ◽  
Rigid Bronchoscopy ◽  
Middle Lobe ◽  
Lobe Bronchus ◽  
Segmental Bronchus ◽  
Foreign Body Extraction ◽  
The Right ◽  
High Level

Introduction. Foreign body aspiration into tracheobronchial tree represents an urgent condition at high level of risk. Etiology is different, and this condition is typical for all ages with highest incidence in pediatric population. Case report. A successful foreign body removal (partial denture) in a 34-year old man was presented. Radiography and computerized tomography of the chest showed a foreign body localized at the level of the right bronchus including the right middle lobe bronchus. By the use of rigid bronchoscopy, a foreign body was visualized and mobilized from the segmental bronchus in the first act, and then completely extracted. Conclusion. Efficient diagnostics and extraction are imperative for the aspirated foreign body preventing life-threatening complications.

scholarly journals An aberrant mediastinal medial basal segmental pulmonary artery (A7a) in a patient with lung cancer: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yoshiaki Takase ◽  
Hiroyoshi Tsubochi ◽  
Ei Yamaki ◽  
Osamu Kawashima
Keyword(s):  
Lung Cancer ◽  
Colon Cancer ◽  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Accurate Information ◽  
3D Ct ◽  
Lobe Bronchus ◽  
The Right

Abstract Background Mediastinal branching of the A7a from the right main pulmonary artery (PA) is extremely rare. Herein, we report a patient with an aberrant mediastinal A7a who underwent right basal segmentectomy for lung cancer. Case presentation A 73-year-old man was referred to our department for a right lower lobe nodule measuring 18 mm in diameter on computed tomography (CT). Three-dimensional (3D) CT revealed mediastinal A7a branching from the right main PA. As the patient had undergone colectomy for advanced ascending colon cancer, the nodule was suspected to be a metastasis from the colon primary, and thus, basal segmentectomy of the right lung was performed. Intraoperatively, the A7a was observed behind the V4+5 and middle lobe bronchus. The pathological diagnosis was combined small cell carcinoma with an adenocarcinoma component (p-T1cN0M0, stage IA3). The patient subsequently received adjuvant chemotherapy for colon cancer. At 1-year postoperative follow-up, there was no evidence of disease. Conclusion This is the first report describing an aberrant mediastinal A7a branching from the right main PA. It is important to obtain accurate information about variations of the PA using 3D-CT for safe anatomical pulmonary resection.

scholarly journals Specific techniques for right sleeve lower lobectomy: four case reports

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hirokazu Hamasaki ◽  
Chika Shirakami ◽  
Tatsuya Yamada ◽  
Yamato Motooka ◽  
Kosuke Fujino ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Function ◽  
Clinical Outcomes ◽  
Case Reports ◽  
Middle Lobe ◽  
The Other ◽  
Case Presentation ◽  
Bronchial Anastomosis ◽  
Lower Lobectomy

Abstract Background Right sleeve lower lobectomy is rarely performed because pulmonary function of the middle lobe is not spared to the extent of the other lobes and achieving a proper bronchial anastomosis is technically more difficult than other sleeve lobectomies. Case presentation We performed four right sleeve lower lobectomies and had good clinical outcomes using specific technical options, such as telescope anastomosing, pericardiotomy, interlobar dissection between the upper and middle lobes, and angioplasty of the lower pulmonary artery, if needed. Conclusions The cases presented herein demonstrated that a right sleeve lower lobectomy is one option by which to preserve the middle lobe using specific techniques and is thus recommended in select patients.

scholarly journals A Delayed Anatomic Diagnosis and Management Challenge in an Initially Asymptomatic Infant With Type II Pulmonary Artery Sling: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoqing Shi ◽  
Chuan Wang ◽  
Yimin Hua ◽  
Xiaoliang Liu ◽  
Hongyu Duan
Keyword(s):  
Pulmonary Artery ◽  
Tracheal Stenosis ◽  
Clinical Symptoms ◽  
Left Pulmonary Artery ◽  
Bronchial Tree ◽  
Middle Lobe ◽  
Pulmonary Artery Sling ◽  
Lobe Bronchus ◽  
Recurrent Wheezing ◽  
Poor Outcomes

Pulmonary artery sling (PAS) is a rare but fatal malformation. Patients with PAS tend to develop obstructive symptoms in few weeks of life. Conversely, some patients may be otherwise mild or asymptomatic in their early life. Currently, no consensus on the intervention timing and treatment strategy for asymptomatic and mild cases has been reached. Moreover, the extent of tracheal stenosis is another determining factor for the choice of intervention timing since clinical symptoms might not correspond well with the degree of stenosis. Lack of comprehensive assessment of entire airways confer underestimation of disease severity and in turn improper choice of treatment regimens and poor outcomes. Herein, we described an infantile case of PAS, who was scheduled initially for periodic outpatient follow-up on account of the absence of symptoms and inadequate imaging assessment at diagnosis. The patient developed recurrent wheezing and progressive respiratory distress at 7 months of age. After left pulmonary artery (LPA) reimplantation without tracheal intervention, bronchoscopy was performed due to failure to wean from mechanical ventilation, which demonstrated complete tracheal cartilage rings, a long segment tracheal stenosis, a low tracheal bifurcation at T6, and the absence of a separate right middle lobe bronchus. The patient was finally diagnosed with type IIb PAS and extubated successfully following conservative treatment. Miserably, neurological sequelae were devastating, leading to poor outcomes. Comprehensive airway evaluation using bronchoscopy is substantial to early identification of all components responsible for airway compromise in PAS anatomic subtypes. Considering severe concomitant maldevelopment of the bronchial tree in children with type IIb PAS, early and complete correction by surgery might decrease perioperative morbidities and mortalities of these patients.

Bubble study as a medium of contrast for computerized tomography coronary angiography. (Preprint)

2020 ◽  
Author(s):  
Vijay Shah ◽  
Justyn Huang
Keyword(s):  
Pulmonary Artery ◽  
Diagnostic Yield ◽  
Negative Contrast ◽  
Hounsfield Unit ◽  
Hounsfield Units ◽  
Computed Tomographic ◽  
Invasive Test ◽  
Clinical Difference ◽  
Contrast Ct ◽  
Scan Protocol

BACKGROUND Computed tomographic coronary angiogram (CTCA) is a non-invasive test with a negative predictive value of nearly 100% for the detection of coronary artery study. While diagnostic yield of a dedicated CTCA with bubble contrast is not yet evaluated OBJECTIVE To assess the diagnostic performance of injected bubble contrast and ability to measure difference in hounsfield units and use it as a "negative contrast" in computed tomographic METHODS This is a single center, single patient study. Baseline acquisition of a non-contrast CT scan was acquired to get hounsfield unit count in the aorta and pulmonary artery- (Calcium scan protocol) 1.4 mGy (19.5 mGy/cm). Secondly, Echo contrasts (Definity) - 5mls was injected and an echocardiogram confirmed filling in the aortic region. Finally, bubble contrast (1ml air, 8mls water and 1mls blood was drawn up and agitated through a 3 way tap) - was injected, a timing run was initiated to calculate for the bubbles to opacity the pulmonary artery. The same scan protocol was used– 1.4 mGy (19.5 mGy/cm). RESULTS Hounsfield units’ difference in the aorta and pulmonary artery from baseline compared to echo contrast and bubble contrast were not significant. CONCLUSIONS We believe this is the first ever recorded case to use bubbles as CT contrast. While results were not significant, secondary to small volume of bubbles injected. Further research needs to be implemented to assess clinical difference with amount of bubbles and volume required. CLINICALTRIAL Single centre study

Sign in / Sign up

Export Citation Format

Share Document