Metallothionein and cadmium nephrotoxicity conference. May 16-18,1983, Research Triangle Park, North Carolina.

Pulmonary artery false aneurysm is a rare condition, reported to complicate interventional procedures. We report a case of a false aneurysm of the interlobar pulmonary artery following a right middle lobectomy for lung cancer. This is probably the first reported case. Background Pulmonary artery false aneurysm is a rare condition, more common in females and with advancing age. It is related to an increase in pulmonary artery pressure [1] and has been described as a complication of vascular interventional procedures [2]. However, pulmonary artery pseudoaneurysm as a postoperative complication of pulmonary resection is unreported. We report a case of a false aneurysm of the interlobar pulmonary artery following a right middle lobectomy. Case presentation A 69-year-old gentleman underwent a right middle lobectomy for a Stage 1A squamous cell carcinoma of his right middle lobe. The operation involved stapling the pulmonary veins using TX30V stapler and double ligation of the pulmonary artery branches. The bronchus was stapled using a TA30 stapler and the minor fissure was completed with a TCT75 linear cutting stapler. The early post-operative course was unremarkable. The patient however was readmitted five weeks postoperatively with pyrexia and an episode of haemoptysis. Chest X-ray showed haziness in the right mid-zone and the patient was treated for a presumed chest infection. He improved and was discharged. A week later, he was readmitted with continuing haemoptysis, swinging pyrexia and increasing shortness of breath at rest. Bronchoscopy revealed granulation tissue near the middle lobe bronchial stump, which bled profusely on biopsy. Blood appeared to be venous in origin. A clot in the lower lobe bronchus was found together with an inflamed and narrowed lower lobe orifice. CT scan showed a false aneurysm of the right descending interlobar pulmonary artery and complete lower lobe collapse and consolidation (Fig 1). The diagnosis of a bronchovascular fistula complicating a false aneurysm was made and the patient was re-explored with a view to completion right lower lobectomy. At the second thoracotomy, there were dense and vascular adhesions throughout the pleural space, which was completely obliterated. Mobilisation of the lung was extremely difficult. The entire lung was consolidated and solid. The pulmonary veins were exceedingly friable and attempt to encircle them caused the vessels to tear and result in massive bleeding. In order to maintain vascular control, a pneumonectomy was considered the safest option under the circumstances. Postoperatively, the Published: 25 August 2007 Journal of Medical Case Reports 2007, 1:70 doi:10.1186/1752-1947-1-70 Received: 18 December 2006 Accepted: 25 August 2007 This article is available from: http://www.jmedicalcasereports.com/content/1/1/70 © 2007 Shaaban et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.