Arranz Arana L, Nogués Pérez A, Mendiola Ruiz R, Loyola Echaniz F
Servicio de Pediatría, Hospital Universitario Donostia, San Sebastián, Spain.
An Pediatr (Barc). 2011 Mar;74(3):182-6. doi: 10.1016/j.anpedi.2010.10.007. Epub 2011 Jan 12.
Hemoptysis and pulmonary hemorrhage are rare pathological entities in childhood, however, both can be life threatening respiratory emergencies and can signify potentially serious underlying intrathoracic disease. We report an 11 year old female who had four episodes of hemoptysis (50 mL of bright red blood within 48 hours) without previous recurrent respiratory problems. The assessment by chest radiography, bronchoscopy and computed tomography (CT) was needed to diagnose the nature of the problem and to indicate the site and extent of the bleeding. The CT angiography of the thorax showed a right bronchial artery hypertrophy, abnormally originated from the aortic arch, next to an aberrant right subclavian artery. The bleeding was successfully controlled by right bronchial arterial embolization with 500-700 μm polyvinyl alcohol (PVA) microspheres. The course was uncomplicated. The bronchial artery embolization is effective in controlling hemoptysis and complications are uncommon in the hand of an experienced operator.
咯血和肺出血在儿童期是罕见的病理情况,然而,两者都可能是危及生命的呼吸急症,并且可能意味着潜在的严重胸内疾病。我们报告一名11岁女性,她有四次咯血发作(48小时内咯出50毫升鲜红色血液),既往无反复呼吸道问题。需要通过胸部X线摄影、支气管镜检查和计算机断层扫描(CT)来评估以诊断问题的性质,并指出出血的部位和范围。胸部CT血管造影显示右支气管动脉肥大,异常起源于主动脉弓,紧邻异常的右锁骨下动脉。通过用500 - 700μm聚乙烯醇(PVA)微球进行右支气管动脉栓塞成功控制了出血。病程无并发症。支气管动脉栓塞在控制咯血方面有效,在经验丰富的操作者手中并发症并不常见。