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J Thorac Cardiovasc Surg 2008;135:208-209
© 2008 The American Association for Thoracic Surgery

Brief Communication

Partial lobar torsion secondary to traumatic hemothorax

^a Division of Cardiothoracic Surgery, Department of Surgery, Washington University, St Louis, Mo
^b Department of Radiology, Washington University, St Louis, Mo.

Received for publication August 6, 2007; accepted for publication August 15, 2007.

^_* Address for reprints: Daniel Kreisel, MD, PhD, Assistant Professor of Surgery, Pathology, and Immunology, Division of Cardiothoracic Surgery, Washington University School of Medicine, 3108 Queeny Tower, One Barnes-Jewish Hospital Plaza, St Louis, MO 63110-1013. (Email: kreiseld@wudosis.wustl.edu).

The first 20% of the full text of this article appears below.

Clinical Summary

A 58-year-old man with a known history of chronic obstructive pulmonary disease was involved in a motor vehicle collision in which he sustained blunt thoracic trauma. At the time of his initial presentation, a chest computed tomographic (CT) scan was obtained, which demonstrated multiple right-sided rib fractures and a moderate ipsilateral pulmonary contusion. Of note, the patient also had bullous emphysema. The patient was admitted for observation and analgesia. On the third day of his hospitalization, the patient started having worsening shortness of breath and had increasing supplemental oxygen requirements. A chest x-ray film obtained 5 days after admission suggested the presence of a new right basilar pleural effusion and a patchy right upper lung opacity consistent with lung contusion (Figure E1). A repeat chest CT scan was obtained, which confirmed a moderate-sized right hemothorax. When compared with the CT scan at admission (Figure 1, A), the twirling appearance of the lung parenchyma with displacement of two large bullae in the right lower lobe were suggestive of a partial lobar torsion (. . . [Full Text of this Article]

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