Wang FQ, Zhang R, Zhang HL, Mo YH, Zheng Y, Qiu GH, Wang Y. Rare location and drainage pattern of right pulmonary veins and aberrant right upper lobe bronchial branch: A case report. World J Clin Cases 2021; 9(32): 9954-9959 [PMID: 34877336 DOI: 10.12998/wjcc.v9.i32.9954]
Corresponding Author of This Article
Yun Wang, MD, PhD, Professor, Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. yunwwang@yeah.net
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Fu-Qiang Wang, Han-Lu Zhang, Yu Zheng, Guang-Hao Qiu, Yun Wang, Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Rui Zhang, Department of Thoracic Surgery, Chengdu Seventh People’s Hospital, Chengdu 610213, Sichuan Province, China
Yun-Hai Mo, Department of Radiology, Chengdu Seventh People’s Hospital, Chengdu 610213, Sichuan Province, China
Author contributions: Wang FQ and Zhang R contributed equally to this work; Wang FQ, Zhang R and Wang Y designed and performed the research; Zhang HL contributed analytic tools; Mo YH, Zheng Y and Qiu GH analyzed the data; Wang FQ wrote the paper; Wang Y revised the paper; all authors have read and approved the final manuscript.
Supported bythe Key Research Project of Sichuan Province, No. 2020YFS0249; and the National Key Research Project of China, No. 2017YFC0113502.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun Wang, MD, PhD, Professor, Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. yunwwang@yeah.net
Received: June 11, 2021 Peer-review started: June 11, 2021 First decision: July 15, 2021 Revised: August 9, 2021 Accepted: September 19, 2021 Article in press: September 19, 2021 Published online: November 16, 2021
Abstract
BACKGROUND
Complex aberration in lung is rare, which may increase risk of vascular injury and cause ligation of wrong pulmonary vein or bronchus by mistake during lung surgery, and result in sever complication like pulmonary congestion or atelectasis.
CASE SUMMARY
A 44-year-old female was admitted for a ground glass nodule (24 mm in diameter) in her right upper lobe. Video-assisted thoracoscopic (VATS) right upper lobectomy with lymph nodes dissection was performed. During operation, we simultaneously identified extremely rare aberrations of right preeparterial bronchus, right upper lobe vein behind pulmonary artery and right middle lobe vein drained into left atrium in this patient. The patient was well recovered and discharged at the postoperative-day 4.
CONCLUSION
Preoperatively, three-dimensional reconstruction can help to identify inconspicuous variation of pulmonary vessels and bronchus effectively. During lung surgery, if anatomic aberration is suspected, careful dissection of vessels and bronchus will help to confirm whether there is an aberration or not.
Core Tip: Complex aberration in lung is rare but inappropriate management of aberration may result in severe complications. In this case, we presented an extremely rare aberrations of right preeparterial bronchus, right upper lobe vein behind pulmonary artery and right middle lobe vein drained into left atrium simultaneously identified in one patient. This case highlights the importance of preoperative three-dimensional reconstruction and careful skeletonization and identification of aberrant anatomic structures during surgery.
