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Eur J Cardiothorac Surg 2004;25:137
© 2004 Elsevier Science NL

Images in cardio-thoracic surgery

Pulmonary azygous lobe: a potential obstacle during thoracoscopic sympathectomy

J. Smith*, S. Karthik, J.A.C. Thorpe

Department of Cardiothoracic Surgery, SHO in Cardiothoracic Surgery, Yorkshire Heart Centre, Leeds General Infirmary, Great George Street, LEEDS LS1 3EX, UK

Received 18 July 2003; received in revised form 21 September 2003; accepted 28 September 2003.

* Corresponding author. Tel.: +44-113-392-5897; fax: +44-113-392-8436
e-mail: drjonsmith{at}hotmail.com

Key Words: Thoracoscopic • Sympathectomy • Azygous lobe

A 35 year-old man underwent bilateral video assisted thoracoscopic symapthectomy for axillary hyperhydrosis. Preoperative chest radiograph revealed an azygous lobe (Fig. 1) . The azygous vein obscured the view partially during adhesiolysis to mobilise the azygous lobe from the parietal pleura (Figs. 2a,b) .



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  		Fig. 1. Close-up view of the right upper zone revealing the azygous lobe and fissure.

 


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  		Fig. 2. (a) (above): Intraoperative thoracoscopic view of the azygous lobe (arrow). (b) (below): Intraoperative thoracoscopic view showing the azygous vein (single arrow) and the adhesions between the pleura and the azygous lobe (double arrow).

 



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