Lung Lobe Torsion Diagnosis and Management

Lung lobe torsion is a rare but potentially fatal condition in which a pulmonary lobe rotates around its bronchovascular pedicle, leading to airway obstruction, vascular compromise and eventual parenchymal infarction. It most commonly arises as an early postoperative complication following lobectomy or bilobectomy but may also occur spontaneously in the presence of tumour, pleural effusion or trauma. Clinical presentation is non-specific, often including sudden dyspnoea, hypoxaemia, chest pain and radiographic findings of atelectasis or a well-defined thoracic opacity. Prompt recognition demands a high index of suspicion and rapid imaging, with contrast-enhanced computed tomography serving as the diagnostic cornerstone. Bronchoscopy may confirm bronchial obstruction. Definitive management is surgical: early detorsion may salvage the lobe if performed before irreversible ischaemia; more commonly, resection of the affected lobe is required. Preventive strategies during initial thoracic surgery—such as fixation of adjacent lobes with sutures, pericardial fat or bridging materials—have been developed to reduce incidence. Minimally invasive approaches, including video-assisted thoracoscopic surgery, are increasingly favoured for both diagnosis and management, offering reduced morbidity and faster recovery. Ongoing refinements in surgical technique and perioperative imaging protocols aim to improve outcomes and prevent catastrophic sequelae of torsion.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Lung Lobe Torsion Diagnosis and Management publication trend

The graph below shows the total number of articles in lung lobe torsion diagnosis and management across all publications each year (not limited to Nature Index journals).

Technical terms

Lobar torsion: Rotation of a lung lobe around its bronchovascular pedicle, causing acute airway and vascular obstruction.

Lobectomy: Surgical removal of a pulmonary lobe, typically performed to treat malignancy or severe infection.

Video-assisted thoracoscopic surgery (VATS): A minimally invasive surgical approach using small ports and a thoracoscope to access the thoracic cavity.

Bronchovascular pedicle: The combined bronchus, pulmonary artery and vein that supply a lung lobe and form its vascular and airway attachment.

References

1. Pulmonary lobar torsion: a rare complication following pulmonary resection, but one not to miss. BJR|case reports (2016).
2. Spontaneous torsion of the right upper lung lobe: a case report. Surgical Case Reports (2017).
3. Surgical technique for preventing lung torsion after right upper and lower bilobectomy. Interdisciplinary CardioVascular and Thoracic Surgery (2023).
4. A simple reproducible method of preventing lobar torsion. Journal of Cardiothoracic Surgery (2008).