We treated a 54-year-old man with an anastomotic obstruction after a right upper sleeve lobectomy. By using minimum intensity projection images that were generated from helical computed tomographic data sets that indicated a twisted slit enhanced with air a few millimeters in length, through anastomosis to the distal bronchus, we successfully treated the obstruction by bronchoscopic balloon dilatation. (Ann Thorac Surg 1999;67:847-9) (C) 1999 by The Society of Thoracic Surgeons.