PMC9483014_01
Axial (A) and sagittal (B) view of CT shows the laceration of the bronchial wall in the middle lobe of right lung. The red arrow indicates the location of the laceration. CT 3D reconstruction (C) shows that the bronchi are continuous and intact, while the laceration is clearly demonstrated in bronchoscopy (D).
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F1
When the CT scan was repeated 4 days post-surgery, interruption of the right middle lobe endobronchial wall was found in the axial and sagittal view (Figures 1A,B) but chest CT with three-dimensional reconstruction shows no obvious rupture or laceration of the tracheobronchial tree (Figure 1C). Incomplete laceration of the right middle lobe bronchus was suspected, which was confirmed by a bedside bronchoscopy after removing the secretion and sputum in the patient's airway (Figure 1D).
(A) Open surgical field. The arrow indicates the opening of the bronchial dissection seen during surgery. (B) Postoperative bronchoscopy confirmed good closure of the bronchial stump. RUL, right upper lobe; RML, right middle lobe; RLL, right lower lobe.
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F2
During the procedure, we found that the middle lobe bronchus was incompletely disrupted, as the small laceration became visible only after the removal of the tissue and cystic membrane surrounding the middle lobe bronchus (Figure 2A). The surgery was timely and successful, and postoperative bronchoscopy confirmed good closure of the bronchial stump (Figure 2B).