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We present an 11-year-old girl with acute myelogenous leukemia and hemoptysis from abscess erosion into the descending thoracic aorta. We report a pediatric case of an aortobronchial fistula treated with an aortic endograft and discuss the technical limitations and potential complications of this procedure.
Dieulafoy's disease is a vascular anomaly characterized by the presence of a tortuous dysplastic artery in the submucosa. The condition was first described as a cause of gastrointestinal bleeding in the stomach. Recently, there have been a few reports of Dieulafoy's disease involving the respiratory tract. Herein, we report 2 patients with massive hemoptysis who were treated with surgical resection and later diagnosed with bronchial Dieulafoy's disease.
Intralobar sequestration is a rare abnormality usually diagnosed at later age after a history of recurrent pulmonary infections. We present a case of a 55-year-old man in whom both hemoptysis and massive hemothorax were the initial presenting symptoms. This report shows that intralobar sequestration can have a dramatic course of disease, and for this reason resection of the sequestered tissue should be considered in all patients.
Hemoptysis and septicemia 6 years after coronary artery bypass surgery in a 56-year-old man was caused by a 5-cm vein graft pseudoaneurysm bleeding into the right pleura and lung parenchyma. The graft was approached through a right thoracotomy. The patient suffered postoperative neuromyopathy, but fully recovered within 6 months without muscular, respiratory, or cardiac symptoms.
We report a rare case of spontaneous dissection of an anomalous systemic artery supplying a normal basal segment of the right lung during pregnancy, leading to recurrent hemoptysis. This article aims to discuss the clinical presentation, diagnostic curiosity, management using a minimally invasive technique (video-assisted thoracoscopic lobectomy), and finally the histopathologic findings.
In this report, we describe successful treatment of a patient with hemoptysis by false lumen embolization of a type B aortic dissection.
To determine risk factors associated with fatal hemoptysis (FH) in endobronchial high dose-rate brachytherapy (EHDRB) 84 patients treated with EHDRB from January 1991 to June 2002 were studied. Clinical and technical parameters (including treatment volumes) were analyzed. Eight (9.5%) patients died of FH, all but one with recurrent or persistent local disease. Median interval until death due to FH was 4 months versus 6 months for the whole group. The only factor with significant correlation with FH was the 100% isodose volume (V100) (p=0.04). Larger irradiated volumes were related to FH. Analysis of volume parameters is suggested, together with the dose and number of fractions prescribed for each patient.
Three patients with very similar clinical symptoms, i.e. hemoptysis and coughing up of staples some time after volume-reducing surgery, are described. There was no deterioration in lung function, nor in the patient's well-being, which could be ascribed to the coughing up of the staples. Thus, staples can some time after volume reducing surgery erode out into the bronchi and be coughed up, often with some small amounts of blood. This has no clinical significance other than the disturbing symptoms. Possibly, the calf pericardium used as strenghtener of the suture lines will with time cause an immunological reaction, causing destruction of the foreign material and thereby dislodging the staples.
Infective endocarditis presenting as an isolated right ventricular outflow tract mass is rare. We report a 34-year-old man with no history of congenital heart defect or intravenous drug abuse who presented with hemoptysis and fevers. Diagnostic workup revealed isolated right ventricular outflow tract vegetation. Despite aggressive antibiotic treatment for endocarditis, he developed septic emboli and acute respiratory distress. He was taken to the operating room for successful resection of the ventricular mass.
We present a rare complication of median sternotomy in which a segment of fractured sternal wire punctured the heart, embolized to the right lung, and eroded into a bronchus causing massive hemoptysis. It was safely removed through a median sternotomy. Sternal wire fracture or migration is diagnosed easily on chest roentgenograms, but frequently goes unnoticed. Sternal wire failure can be managed nonoperatively; however, repair is indicated if fractured wires are displaced or potentially migratory.
This case report describes a subhepatic abscess from spilled gallstones which eroded through the diaphragm causing a right lower lobe pulmonary abscess and presenting as massive hemoptysis.
Catamenial hemoptysis is a rare result of thoracic endometriosis. The long-term treatment of this condition remains controversial. An operation to remove the offending parenchymal endometrial tissue by pulmonary sparing, such as wedge resection, segmentectomy affords satisfactory treatment without the disadvantage of long-term hormone therapy and with the consequent suppression of normal menses and alteration of secondary sexual characteristics in a young woman.
A 54-year-old man was seen with massive hemoptysis. A posteroanterior chest radiograph revealed increased bronchovascular branching in the left hemithorax. Thoracic computed tomography showed a well-demarcated mass with uniform density confined to the apicoposterior and anterior segments of the left upper lobe. Fiberoptic bronchoscopy revealed a locus of bleeding in the apicoposterior segment of that lobe. Exploratory left thoracotomy confirmed the presence of a mass. The results of frozen section examination of a biopsy specimen were benign. The mass was resected by upper lobectomy. The definitive result of histopathological study of the mass was cavernous hemangioma. Very few cases of pulmonary hemangioma have been reported in the literature.
A 39-year-old man presented with massive hemoptysis requiring emergency double lumen endobronchial intubation, bronchial arteriography and embolization, and subsequent right lower lobectomy. He had suffered a shrapnel blast injury to the right chest as a 9-year-old boy. Pathology of the resected specimen revealed lodged metallic foreign body with traumatic arteriovenous malformation. We present this case to alert thoracic surgeons to this extremely rare clinical entity that can present itself many years after the penetrating trauma, which requires urgent surgery.
We report the case of a 64-year-old woman who presented with massive hemoptysis. She was found to be bleeding from a pulmonary arteriovenous malformation in the right middle lobe, which had a peculiar blood supply from the right internal mammary artery. Video-assisted thoracic surgery lobectomy was successfully performed for this condition. Limitations of embolization as a treatment modality for this condition are discussed.
We report a case of Klippel-Trenaunay-Weber syndrome presenting with hemoptysis.
A patient undergoing mitral and aortic valve replacement suffered catheter-induced pulmonary artery trauma and massive hemoptysis during weaning from cardiopulmonary bypass. Hemorrhage ceased when the ipsilateral pulmonary artery was occluded. Forty-eight hours later the temporary band was removed, and the patient did well without further bleeding.
The clinical management of massive hemoptysis in patients with cystic fibrosis proceeds according to the following paradigm. The site of bleeding is identified by bronchoscopy, ideally under general anesthesia. Then selective bronchial arteriography is performed. If collaterals to the spinal cord are visualized, arterial embolization is abandoned and pulmonary resection is undertaken within the limits of pulmonary function.