Awouda Elrasheid Ali, Elnori Ahmed Anwar, Ahmed AlaEldin Hassan
Department of Respiratory Medicine, Elshaab Teaching Hospital, Khartoum, Sudan.
Department of Cardiothoracic Surgery, Ain Shams Faculty of Medicine, Ain Shams, Cairo, Egypt.
BMJ Case Rep. 2017 Jan 11;2017:bcr2016217794. doi: 10.1136/bcr-2016-217794.
We report a case of a 39-year-old man who presented with coughing up blood for 5 days. On the day of admission, he coughed up about 300 mL of fresh blood. He mentioned that he has had cough for the past 10 years. On clinical examination, he was afebrile, tachypneic, tahycardic and normotensive. Rest of the physical examination was normal. His oxygen saturation breathing room air was 96%. His full blood count showed haemoglobin 9.3 g/dL. His chest radiograph was reported as normal. CT chest showed a vascular right paracardiac soft tissue density. On the basis of this, a diagnosis of pulmonary sequestration was considered. CT angiography of the soft tissue density identified multiple sources of systemic arterial blood. Two arteries were arising from the descending aorta and a third artery was coming from the right renal artery. Surgical removal of the sequestrated lobe was performed. The patient has an uneventful postoperative recovery and remained well at follow-up 2 months after surgery.
我们报告一例39岁男性,其咯血5天。入院当天,他咳出约300毫升鲜血。他提到过去10年一直咳嗽。临床检查时,他无发热,呼吸急促,心动过速,血压正常。其余体格检查正常。他在室内空气中的氧饱和度为96%。他的全血细胞计数显示血红蛋白9.3g/dL。胸部X线片报告正常。胸部CT显示右心旁血管软组织密度影。基于此,考虑诊断为肺隔离症。对软组织密度影进行CT血管造影,发现多个体循环动脉血来源。两条动脉发自降主动脉,第三条动脉来自右肾动脉。对隔离肺叶进行了手术切除。患者术后恢复顺利,术后2个月随访时情况良好。