Umeki S, Mochizuki Y, Yagi S, Soejima R, Wakunami M, Nogami A, Katsunuma T, Hirokawa M
Department of Medicine, Kawasaki Medical School.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Jul;28(7):999-1005.
A 64-year-old man was referred to our hospital because of little improvement of hemoptysis lasting three days after drug therapy. A chest roentgenogram and fiberoptic bronchoscopic examination performed on the second hospital day when the patient experienced a massive hemoptysis of about 2,000 ml revealed arterial bleeding from the left upper lobe. Even after extensive embolizations of the left upper bronchial, the first, second, third and 4th intercostal arteries, the patient's hemoptysis did not improve. On the 73rd hospital day the patient underwent left upper lobectomy. Macroscopic and microscopic examinations in the resected specimen revealed lung injury due to a torn segment of pleural calcification after tuberculous pleuritis, resulting in the massive hemoptysis. Although physicians encounter many patients complaining of hemoptysis and/or hemosputum, this case is considered to be very rare.
一名64岁男性因药物治疗三天后咯血症状改善甚微而被转诊至我院。在入院第二天，患者出现约2000毫升的大量咯血，此时进行的胸部X光片和纤维支气管镜检查显示左上叶动脉出血。即便对左上支气管、第一、第二、第三和第四肋间动脉进行了广泛栓塞，患者的咯血症状仍未改善。在住院第73天，患者接受了左上叶切除术。对切除标本的宏观和微观检查显示，由于结核性胸膜炎后胸膜钙化段撕裂导致肺损伤，进而引发大量咯血。尽管医生会遇到许多抱怨咯血和/或痰中带血的患者，但该病例被认为非常罕见。
