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Radiographic and CT Findings of Thoracic Complications after Pneumonectomy¹

¹ From the Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poong-nap-dong, Songpa-ku, Seoul 138-36, Korea. Presented as an education exhibit at the 2003 RSNA Annual Meeting. Received August 3, 2005; revision requested September 13 and received October 31; accepted October 31. All authors have no financial relationships to disclose. Address correspondence to J.B.S. (e-mail: seojb{at}amc.seoul.kr).

Pneumonectomy is the treatment of choice for bronchogenic carcinoma and intractable end-stage lung diseases such as tuberculosis and bronchiectasis, but it is often followed by postoperative complications, which account for significant morbidity and mortality. Knowledge of the radiologic features of such complications is of critical importance for their early detection and prompt management. Complications of pneumonectomy are classified as early or late, depending on when they occur in relation to the hospitalization period. Early complications of pneumonectomy include pulmonary edema, bronchopleural fistula, pneumonia of the contralateral lung, empyema, and adult respiratory distress syndrome, which may occur separately or in combination. Late postpneumonectomy complications include recurrent disease, infection, effects of radiation therapy or chemotherapy, and surgical complications such as late-onset bronchopleural fistula, postpneumonectomy syndrome, and esophagopleural fistula. Sequential examinations with chest radiography after pneumonectomy are an invaluable method of screening for these complications, especially in the early postoperative period. When the radiographic findings are inconclusive, computed tomography is helpful for establishing a diagnosis and obtaining detailed information about the disease process.

© RSNA, 2006