Venous Branching Pattern in a Patient with Hemorrhagic Infarction in the Lingula after the Upper Division Resection of the Left Lung

Background: Because left upper division resection is similar to right upper lobectomy, this procedure is frequently employed. Few studies have used the anatomic courses of veins evaluated on preoperative computed tomography (CT) imaging to determine what types of patients are at the highest risk for hemorrhagic pulmonary infarction. Case: We describe our experience with a patient in whom hemorrhagic pulmonary infarction occurred at 6 days after transecting two superior branches (V(1) and V(3)) of the three branches of the left superior pulmonary vein. We preoperatively confirmed that small-caliber lingular veins were perfused by V(3). However, the patient had a poor pulmonary function, and the tumor was located distal to V(3). Left upper division resection was therefore performed. Conclusion: The division of V(3) could be the cause of hemorrhagic infarction in the lingular segment after upper division segmentectomy.