Lung lobe torsion (LLT) occurs when a lung lobe rotates along its long axis, causing constriction of the bronchus and vessels at the hilus (Figure 1). This life-threatening disorder requires immediate surgical intervention.

Figure 1. Intraoperative image of a congested, torsed lung lobe. Affected lung tissue is often necrotic and friable. Courtesy of Dr. Karen Tobias, University of Tennessee College of Veterinary Medicine.

Overview

LLT occurs spontaneously or secondary to a predisposing condition, such as chylothorax, pleural effusion, or chronic respiratory disease. LLT’s pathophysiology is poorly understood but may involve partial collapse of a lung lobe, either spontaneously or secondary to disease, that leads to altered spatial association and increased relative lung mobility.1 Large, deep-chested dog breeds have a higher incidence of LLT than small-breed dogs; however, pugs may be predisposed.1 Right middle and left cranial lung lobes are most commonly affected.2,3 Median age is 3 years, although LLT has been reported in a 7-week-old pug.3,4


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