Pneumonectomy

Dr Daniel J Bell and Dr Ian Bickle et al.

Pneumonectomy is a radical lung surgery involving complete surgical removal of the lung. It is most commonly performed for a primary lung malignancy. The lung is removed in its entirety providing the patient has adequate pulmonary reserve from the contralateral lung.

Recognized post-pneumonectomy complications include:

Radiographic features

The typical course of possible appearances on imaging following pneumonectomy are:

  • acutely, there is partial filling of the hemithorax with a combination of fluid, air/gas and contralateral lung and mediastinum
  • mediastinal shift occurs gradually accompanied by hyperinflation of the contralateral lung and herniation
  • sequential chest radiographs should demonstrate increasing fluid and decreasing gas within the pneumonectomy space, which is evident by a gas-fluid level which gradually rises
    • if the gas-fluid level starts to lower, a bronchopleural fistula is suspected
  • sequential chest radiographs should demonstrate gradual volume loss on the pneumonectomy side
Plain radiograph

Pneumonectomy is one of the causes of a white out of the hemithorax. The hemithorax is completely opacified with the trachea pulled towards the side of the abnormality. Surgical clips may be identified at the lung hilum.

CT

The lung is absent on the side of surgery, with resultant mediastinal shift and compensatory hyperinflation of the contralateral lung.

See also

Article information

rID: 26490
System: Chest
Section: Gamuts
Synonyms or Alternate Spellings:
  • Pneumonectomies

ADVERTISEMENT: Supporters see fewers/no ads

Cases and figures

  • Case 1
    Drag here to reorder.
  • Case 2
    Drag here to reorder.
  • AP chest xray day...
    Case 3: early findings
    Drag here to reorder.
  • Case 4
    Drag here to reorder.
  • Case 5
    Drag here to reorder.
  • Case 6: CT right-sided pneumonectomy
    Drag here to reorder.
  • Case 7
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.