Padrones Susana Sanchez, Lisbona Rosa Lopez, Gratacos Antoni Rosell, Rodriguez Alicia Noemi, Diaz-Jimenez Jose Pablo
Pulmonary Department and Laser Department, Bellvitge University Hospital, Barcelona, Spain; and Pulmonary Department, Clinica Colon Mar del Plata, Argentina.
J Bronchology Interv Pulmonol. 2009 Oct;16(4):274-6. doi: 10.1097/LBR.0b013e3181b64108.
A 48-year-old smoker and alcoholic patient was admitted for life-threatening hemoptysis. The admission bronchoscopy showed a tumoral mass almost occluding the right bronchus intermedious. During the procedure the patient developed massive bleeding and underwent selective aortic angiogram and coiling of 2 bronchial arteries. After the patient stabilized, a contrast thoracic computed tomography was performed, revealing a right pulmonary artery pseudoaneurysm. On the basis of that finding, a selective right pulmonary artery angiogram was performed, showing a 3.4-cm-diameter pseudoaneurysm that was embolized. Hemoptysis resolved after the procedure, but the patient developed parenchymal ischemia-infarct on the treated area (right lower lobe). A pulmonary artery pseudoaneurysm can arise from a lung tumor and cause massive hemoptysis. Although unusual, ischemia and infarct can occur after embolotherapy.
一名48岁有吸烟和酗酒史的患者因危及生命的咯血入院。入院时支气管镜检查显示一个肿瘤块几乎完全阻塞了右中间支气管。在检查过程中,患者出现大量出血,并接受了选择性主动脉血管造影和两支支气管动脉的栓塞治疗。患者病情稳定后,进行了胸部增强计算机断层扫描,发现右肺动脉假性动脉瘤。基于这一发现,进行了选择性右肺动脉血管造影,显示一个直径3.4厘米的假性动脉瘤并对其进行了栓塞。术后咯血症状消失,但患者在治疗区域(右下叶)出现实质缺血梗死。肺动脉假性动脉瘤可由肺部肿瘤引起并导致大量咯血。虽然不常见,但栓塞治疗后可能会发生缺血和梗死。