Unilateral pulmonary vein atresia is a rare congenital anomaly characterized by the absence of the pulmonary veins on the involved side. It is usually detected in childhood with recurrent episodes of pulmonary infections and dyspnoea on exertion. However, it might be first detected in adulthood with symptoms of pulmonary arterial hypertension and hemoptysis. Pulmonary angiography is usually considered a diagnostic tool. We present this case report with incidentally diagnosed unilateral pulmonary venous atresia with a small atrial septal defect in a 63-year old adult during metastatic work for carcinoma sigmoid colon. Our patient never had an episode of hemoptysis and the entire diagnosis including vascular and parenchyma changes of unilateral pulmonary vein atresia was done using a 64 slice multidetector Computed tomography (CT) scan obviating the need for pulmonary angiography.
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