Surgical resection of a pulmonary artery pseudoaneurysm after middle lobectomy: Report of a case

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  • Miyazaki Takuro
    Departments of Surgical Oncology ,Nagasaki University Graduate School of Biomedical Sciences
  • Yamasaki Naoya
    Departments of Surgical Oncology ,Nagasaki University Graduate School of Biomedical Sciences
  • Tsuchiya Tomoshi
    Departments of Surgical Oncology ,Nagasaki University Graduate School of Biomedical Sciences
  • Matsumoto Keitaro
    Departments of Surgical Oncology ,Nagasaki University Graduate School of Biomedical Sciences
  • Shimoyama Koichiro
    Departments of Surgical Oncology ,Nagasaki University Graduate School of Biomedical Sciences
  • Taniguchi Daisuke
    Departments of Surgical Oncology ,Nagasaki University Graduate School of Biomedical Sciences
  • Kinoshita Naoe
    Departments of Pathology, Nagasaki University Graduate School of Biomedical Sciences
  • Nagayasu Takeshi
    Departments of Surgical Oncology ,Nagasaki University Graduate School of Biomedical Sciences

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A case of surgical resection of a pulmonary artery pseudoaneurysm after middle lobectomy is reported. A 76-year-old man with lung cancer, interstitial pulmonary fibrosis, and pneumoconiosis was referred for surgical resection. Right middle lobectomy with lymph node dissection was successfully performed. Postoperatively, the patient did well until a sudden high fever developed on postoperative day eight. Antibiotic therapy was started for suspected acute pneumonia, but the low-grade fever did not improve. Contrast-enhanced computed tomography showed a bronchopleural fistula that caused a pulmonary artery pseudoaneurysm. Right lower lobectomy via posterolateral thoracotomy was performed to resect the pseudoaneurysm. The pulmonary artery stump was sutured by monofilament unabsorbable stiches. The bronchus stump was sutured interruptedly with a pedicle of intercostal muscles. The patient’s postoperative course following repeat thoracotomy was complicated, including exacerbation of interstitial pneumonia and tracheostomy. He is still in hospital, and weaning off the mechanical ventilator is being attempted.

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