A new non-invasive diagnostic method for lung lobe torsion: pulmonary CT angiography

Torsion of the remaining lung lobe after lobectomy is an uncommon event which is difficult to diagnose and may result in hemorrhagic infarction and fatal gangrene. We report a case of right upper lobe torsion after middle lobe resection for bronchiectasis, diagnosed with noninvasive pulmonary computerized tomography (CT) angiography. Rethoracotomy with an upper lobectomy was performed. She was asymptomatic at the two-year follow-up. Although the bronchoscopy has a great value in the diagnosis, CT angiography is an effective noninvasive method for confirming the correct diagnosis. A high index of clinical suspicion, early diagnosis and aggressive management may improve survival.     

Right coronary artery hepatic vein fistula: a case report

There is a slight predominance for coronary artery fistulas that involve the right coronary artery, while multiple fistulas have also been reported. The usual site of termination is one or more of the low-pressure structures in the heart or the great vessels such as the right or left atria, right ventricle, coronary sinus, pulmonary artery, or superior vena cava. However, a coronary fistula that drains into a hepatic vein has not been reported in the literature. Therefore, this is the first case report indicating a right coronary artery fistula that drains into the middle hepatic vein.