title: Lobar torsion complicating bilateral lung transplantation.
abstract: We report a case of left lower lobe torsion in a patient who had undergone bilateral lung transplantation for alpha(1)-antitrypsin deficiency. The patient experienced acute pulmonary hypertension and hypoxemia on post-operative Day 3 and the chest X-ray showed bilateral alveolar infiltrates and a new focal consolidation of the left lower lobe. Fiberoptic bronchoscopy showed complete obstruction of the left lower lobe bronchus and abnormal rotation of the left upper lobe bronchus suggesting torsion, which was confirmed by pulmonary angiography and ultimately at thoracotomy. The possibility of acute lobar torsion should be considered in lung transplant recipients who demonstrate evidence of acute respiratory insufficiency in the early post-operative period.
authors.affiliation: Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA. Todd.Grazia@uchsc.edu
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Grazia
authors.forename: Tony N
authors.initials: TN
authors.lastname: Hodges
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Cleveland
authors.forename: Brett C
authors.initials: BC
authors.lastname: Sheridan
authors.forename: Martin R
authors.initials: MR
authors.lastname: Zamora
mesh_terms: D006801:Humans; D008171:Lung Diseases / Q000209:etiology* / Q000601:surgery; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D014102:Torsion Abnormality / Q000209:etiology / Q000601:surgery