Chadha Davinder, Handa Ajay, Chandra Subash
Department of Cardiology, MH (CTC), Pune, Maharashtra, India.
BMJ Case Rep. 2013 Jan 25;2013:bcr2012008205. doi: 10.1136/bcr-2012-008205.
A 17-year-old boy reported for evaluation of two episodes of massive haemoptysis. His clinical examination was unremarkable and investigations (haemogram, coagulogram, serological tests for connective tissue disorders) were normal. A 64-slice CT angiography revealed a saccular aneurysm of 3.8×3.7×3.3 cm arising from the right lower lobe pulmonary artery which was confirmed by cardiac catheterisation. The aneurysm was successfully blocked with a 16-14 Amplatzer duct occluder. A repeat CT angiogram performed after 15 days revealed the device in situ obliterating the aneurysm. Pulmonary artery aneurysm is an extremely rare cause of massive haemoptysis and indicates imminent rupture of the aneurysm which can be rapidly fatal. This case highlights the importance of using an innovative endovascular technique for treatment of a rare cause of haemoptysis.
一名17岁男孩因两次大量咯血前来评估。他的临床检查无异常,各项检查(血常规、凝血功能检查、结缔组织疾病血清学检查)均正常。64层CT血管造影显示右肺下叶肺动脉有一个3.8×3.7×3.3 cm的囊状动脉瘤,心脏导管检查证实了这一结果。该动脉瘤用16-14型Amplatzer封堵器成功封堵。15天后进行的重复CT血管造影显示该装置在原位闭塞了动脉瘤。肺动脉瘤是大量咯血极其罕见的原因,提示动脉瘤即将破裂,可迅速致命。本病例突出了采用创新的血管内技术治疗罕见咯血原因的重要性。