[Proximal bronchial cancer with hypoxemia due to right to left intrapulmonary shunt. Correction of hypoxemia after pneumonectomy].
The authors report a case of a patient who was in hospital for a bronchial cancer completely occluding the left superior and inferior lobar bronchi. Respiratory function tests showed: an FEV1 of 1.7 litres, FEV1 (vital capacity ratio of 60%), a TLC of 76% of the predicted value and a PaO2 of 52 mm of mercury with an elevated alveolar arterial oxygen gradient. The ventilation perfusion lung scan showed that the left lung was not ventilated but was perfused. A left pneumonectomy was judged to have removed the cancer and enabled a correction of the hypoxaemia. The authors recall the functional repercussions of absent ventilation of one lung by a proximal bronchial obstruction and the therapeutic implications in the realm of neoplastic pathophysiology.
Kikano
T
T
Service de Pneumologie, Hôpital de la Croix-Rousse, Lyon.
Perol
M
M
Arnouk
H
H
Bayle
J Y
JY
Baulieux
J
J
Guerin
J C
JC
D002283:Carcinoma, Bronchogenic / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D000860:Hypoxia / Q000097:blood / Q000209:etiology*; D008175:Lung Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011652:Pulmonary Circulation
Cancer bronchique proximal avec hypoxémie par shunt droit-gauche intrapulmonaire. Correction de l'hypoxémie après pneumonectomie.