Yujun Li1, Yuyao Wang2, Zhike Liang1, Chuzhi Pan3, Xiaomei Huang1, Zexun Mo1, Guodong Chen4, Dongliang Zhu5, Ziwen Zhao1, Shuquan Wei6. 1. Department of Pulmonary and Critical Care Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Yuexiu District, Guangzhou, 510180, Guangdong, China. 2. Department of Medicine, Danbury Hospital, Danbury, CT, USA. 3. Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Tian He Road, Guangzhou, Guangdong, China. 4. Department of Interventional Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Panfu Road, Guangzhou, Guangdong, China. 5. Department of Interventional Operation Center, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Panfu Road, Guangzhou, Guangdong, China. 6. Department of Pulmonary and Critical Care Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Yuexiu District, Guangzhou, 510180, Guangdong, China. eyweishuquan@scut.edu.cn.
Abstract
BACKGROUND: Life-threatening hemoptysis presents an immediate diagnostic and therapeutic challenge, especially during the perinatal period. CASE PRESENTATION: A 28-year-old perinatal woman with no significant past medical or surgical history presented with repeating hemoptysis and respiratory failure. Computed tomography revealed a 2.1 × 3.2 cm2 inhomogeneous tumorous lesion in the right superior mediastinum and a right main bronchus obstruction along with atelectasis of the right lung. Bronchoscopy showed a tumorous protrusion blocking the right main bronchus with active hemorrhage, and malignancy was suspected. Bronchial artery embolization (BAE) was performed to control the bleeding. The arteriogram revealed tortuosity, dilation and hypertrophy of the right bronchial arteries and aneurysms of the internal thoracic artery (ITA). The bleeding completely stopped after BAE. Bronchoscopy was performed again to remove residual blood clots. The patient recovered soon after the procedure and was discharged. CONCLUSIONS: Life-threatening hemoptysis concomitant with ITA aneurysms, which may have a misleading clinical diagnosis and treatment options, has not been reported previously in perinatal women. BAE could be used as a first-line treatment irrespective of the underlying causes.
BACKGROUND: Life-threatening hemoptysis presents an immediate diagnostic and therapeutic challenge, especially during the perinatal period. CASE PRESENTATION: A 28-year-old perinatal woman with no significant past medical or surgical history presented with repeating hemoptysis and respiratory failure. Computed tomography revealed a 2.1 × 3.2 cm2 inhomogeneous tumorous lesion in the right superior mediastinum and a right main bronchus obstruction along with atelectasis of the right lung. Bronchoscopy showed a tumorous protrusion blocking the right main bronchus with active hemorrhage, and malignancy was suspected. Bronchial artery embolization (BAE) was performed to control the bleeding. The arteriogram revealed tortuosity, dilation and hypertrophy of the right bronchial arteries and aneurysms of the internal thoracic artery (ITA). The bleeding completely stopped after BAE. Bronchoscopy was performed again to remove residual blood clots. The patient recovered soon after the procedure and was discharged. CONCLUSIONS: Life-threatening hemoptysis concomitant with ITA aneurysms, which may have a misleading clinical diagnosis and treatment options, has not been reported previously in perinatal women. BAE could be used as a first-line treatment irrespective of the underlying causes.
Authors: Gabriele Piffaretti; Gianpaolo Carrafiello; Marco Franchin; Anna Maria Ierardi; Giovanni Mariscalco; Patrizio Castelli; Santi Trimarchi Journal: Ann Vasc Surg Date: 2015-07-09 Impact factor: 1.466