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导致一名孕妇发生张力性血胸并需要紧急剖宫产的肺动静脉畸形(AVM)

Pulmonary Arteriovenous Malformation (AVM) Causing Tension Hemothorax in a Pregnant Woman Requiring Emergent Cesarean Delivery.

作者信息

Sood Nidhi, Sood Nikhil, Dhawan Vibhu

机构信息

OSF Saint Francis Medical Center, Peoria, IL 61637, USA.

出版信息

Pulm Med. 2011;2011:865195. doi: 10.1155/2011/865195. Epub 2011 Jun 2.

Abstract

Pulmonary arteriovenous malformations (PAVMs), although most commonly congenital, are usually detected later in life. We present a case of a 25-year-old woman with no previous history of AVM or telangiectasia, who presented with life-threatening hypoxia, hypotension, and pleuritic chest pain in 36th week of gestation. Chest tube placement revealed 4 liters of blood. Patient was subsequently found to have bleeding pulmonary AVM as the source of hemothorax. Successful embolisation of the bleeding vessel followed by thoracoscopic evacuation of the organized clot relieved the hypoxia. Further screening for AVM revealed large splenic AVM for which patient underwent splenectomy in the coming months.

摘要

肺动静脉畸形(PAVM)虽然大多为先天性,但通常在生命后期才被发现。我们报告一例25岁女性病例,该患者既往无动静脉畸形或毛细血管扩张病史,在妊娠36周时出现危及生命的低氧血症、低血压和胸膜炎性胸痛。放置胸腔引流管引出4升血液。随后发现患者出血性肺动静脉畸形是血胸的来源。成功栓塞出血血管,随后通过胸腔镜清除机化血凝块缓解了低氧血症。进一步筛查动静脉畸形发现巨大脾动静脉畸形,患者在接下来的几个月接受了脾切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/724f/3109763/2b5d0f7eaa33/PM2011-865195.001.jpg

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