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Radiographic and CT Findings in Complications Following Pulmonary Resection¹

¹ From the Departments of Radiology (E.A.K., K.S.L., T.S.K., P.S.Y.) and Thoracic Surgery (Y.M.S., J.K., K.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea. Recipient of a Certificate of Merit award for an education exhibit at the 2000 RSNA scientific assembly. Received March 27, 2001; revision requested May 17 and received June 6; accepted June 6. Address correspondence to K.S.L. (e-mail: kslee@smc.samsung.co.kr).

A variety of pulmonary resection techniques are currently available, including pneumonectomy (intrapleural, extrapleural, intrapericardial, and sleeve pneumonectomy), lobectomy, and limited resection (sleeve lobectomy, segmentectomy, nonanatomic parenchyma-sparing resection). However, pulmonary resection is often followed by postoperative complications that differ according to the type of surgery and the time elapsed since surgery was performed. The most common complications are bleeding, pulmonary edema, atelectasis, pneumonia, persistent air leak, bronchopleural fistula, and empyema. Other, less frequent complications include cardiac herniation, lung torsion, chylothorax, anastomotic dehiscence, wound infection, esophagopleural fistula, and recurrent tumor. The radiologist plays a major role in the diagnosis of various complications following pulmonary resection. Unfortunately, chest radiography has a relatively low diagnostic accuracy in the detection of these complications. When radiographic findings are subtle or equivocal, computed tomography frequently allows more accurate identification of the disease process. Several complications that follow pulmonary resection are life-threatening and require prompt management. Therefore, knowledge of the diverse radiologic appearances of these complications as well as familiarity with the clinical settings in which specific complications are likely to occur are vital for prompt, effective treatment.

© RSNA, 2002

Index Terms: Lung, consolidation • Lung, CT, 60.1211 • Lung, diseases, 60.21, 60.24, 60.4125, 60.4127, 60.71, 60.74, 60.76 • Lung, edema, 60.71 Lung, radiography, 60.11 • Lung, surgery, 60.452, 60.453 • Lung, torsion • Surgery, complications, 60.452, 60.453

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