What happened, in summary

A 62-year-old woman underwent surgery for lung adenocarcinoma, including a right upper lobectomy, removal of the S6 segment, and mediastinal lymph-node dissection. Because the remaining right middle lobe was unusually mobile, the surgeons placed a fixation stitch intended to reduce the risk of postoperative twisting.

Five days later, she noticed a new foreign-body sensation in her chest when breathing in. Although she was not short of breath and her oxygen level remained normal, imaging showed collapse and consolidation of the right middle lobe. Bronchoscopy also showed narrowing of the middle-lobe airway.

Emergency surgery confirmed that the right middle lobe had rotated 180 degrees around its vascular and airway attachment. The lobe was severely congested and necrotic even though the original fixation stitch remained in place. Because the tissue was no longer viable, the right middle lobe was removed.

After the second operation, the remaining right lower lobe expanded well and the chest sensation resolved. She recovered in stable condition and was discharged 6 days after the emergency surgery. Her immediate postoperative recovery was stable after the second operation.