Martínez E, Villar I, Pérez S, León M, Rubio T, García C
Servicio de Medicina Interna, Complejo Hospitalario de Navarra, Pamplona.
An Sist Sanit Navar. 2013 Jan-Apr;36(1):159-62. doi: 10.4321/s1137-66272013000100023.
Hemomediastinum caused by rupture of a bronchial artery aneurysm is a very infrequent pathology. Clinical presentation can be variable; it can resemble an aortic pathology and be diagnosed in emergency situations. Computerized tomography (CT) of the thorax is the initial test for diagnosis. We present the clinical case of a 70-year-old man with an initial clinical assessment of transfixive thoracic pain resembling an acute aortic pathology. TC was carried out with a diagnosis of suspected mediastinal neoplasia (Hounsfield Units/HU 38 - soft tissue), biopsy sampling was carried out by gastroscopy and broncoscopy with haemorrhagic pap smear, presenting light anemization on admission and remaining haemodynamically stable and asymptomatic. Facing a high clinical suspicion of arterial pathology, CT was repeated in which hemomediastinum was described in resolution, with subsequent confirmation of the existence of ruptured bronchial artery aneurysm through angiography and proceeding to therapeutic embolization.
支气管动脉瘤破裂导致的纵隔积血是一种非常罕见的病症。临床表现可能多种多样；它可能类似于主动脉病变，并在紧急情况下被诊断出来。胸部计算机断层扫描（CT）是初步诊断的检查方法。我们呈现了一名70岁男性的临床病例，其最初的临床评估为穿透性胸痛，类似于急性主动脉病变。进行了CT检查，诊断为疑似纵隔肿瘤（亨氏单位/HU 38 - 软组织），通过胃镜和支气管镜检查及出血性巴氏涂片进行活检取样，入院时出现轻度贫血，血流动力学保持稳定且无症状。由于高度怀疑存在动脉病变，再次进行了CT检查，结果显示纵隔积血已消退，随后通过血管造影证实存在破裂的支气管动脉瘤，并进行了治疗性栓塞。
