[Proximal bronchial cancer with hypoxemia due to right to left intrapulmonary shunt. Correction of hypoxemia after pneumonectomy].

The authors report a case of a patient who was in hospital for a bronchial cancer completely occluding the left superior and inferior lobar bronchi. Respiratory function tests showed: an FEV1 of 1.7 litres, FEV1 (vital capacity ratio of 60%), a TLC of 76% of the predicted value and a PaO2 of 52 mm of mercury with an elevated alveolar arterial oxygen gradient. The ventilation perfusion lung scan showed that the left lung was not ventilated but was perfused. A left pneumonectomy was judged to have removed the cancer and enabled a correction of the hypoxaemia. The authors recall the functional repercussions of absent ventilation of one lung by a proximal bronchial obstruction and the therapeutic implications in the realm of neoplastic pathophysiology.