CTICasesLobar Torsion
[...]. Lobar Torsion. CTICases. Published August 28, 2021. https://str-case-explorer.pages.dev/c/zx94h
Imaging findings
CT demonstrates left upper lobe consolidation with a "bird's nest" pattern resembling a venous infarct. The pulmonary bronchus to the left upper lobe is narrowed and terminates abruptly, and there is beaking of the left pulmonary artery. A second case shows similar findings of left lower lobe consolidation with a twisting course of the hilum vessels.
Key takeaways
Pulmonary lobar torsion is a rare, life-threatening complication that can occur after thoracic surgery, such as trauma-related thoracotomy or lung transplantation. Key imaging findings include lobar consolidation with a ground-glass or hemorrhagic infarction pattern, abrupt bronchial narrowing or occlusion, and tapered "beaking" of the lobar pulmonary artery. Rapid recognition is critical, as emergency reoperation is required to resect the infarcted, necrotic lobe.
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