一例伴有大量咯血的支气管动脉动脉瘤破裂。
A ruptured bronchial artery aneurysm with massive haemoptysis.
作者信息
Ueda Ryoma, Kotani Yuki, Tsujimoto Toshihide
机构信息
Critical Care Medicine, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan.
出版信息
BMJ Case Rep. 2017 May 22;2017:bcr-2017-220392. doi: 10.1136/bcr-2017-220392.
Massive haemoptysis is associated with high mortality. Among various diseases presenting with massive haemoptysis, a ruptured bronchial artery aneurysm (BAA) is a rare entity. We report the case of a ruptured BAA as small as 3 mm in diameter associated with massive haemoptysis in a previously healthy 77-year-old woman. She had suddenly developed massive haemoptysis and was intubated and admitted to the intensive care unit. A CT scan and repeated bronchoscopy could not reveal the cause. Because haemorrhage continued, she underwent bronchial arteriography (BAG) twice. We finally detected a BAA with a bleb that led to the diagnosis of a ruptured BAA only 3 mm in diameter. After bronchial artery embolisation, the haemoptysis ceased. Although rare, a ruptured BAA should be considered as a cause of massive haemoptysis. Because a small BAA may get overlooked, close observation is important in BAG.
大量咯血与高死亡率相关。在出现大量咯血的各种疾病中，支气管动脉动脉瘤（BAA）破裂是一种罕见情况。我们报告一例直径仅3毫米的BAA破裂病例，该病例发生在一名77岁既往健康的女性身上，伴有大量咯血。她突然出现大量咯血，随后插管并入住重症监护病房。CT扫描和反复支气管镜检查均未能揭示病因。由于出血持续，她接受了两次支气管动脉造影（BAG）。我们最终检测到一个带有小泡的BAA，从而确诊为直径仅3毫米的BAA破裂。支气管动脉栓塞术后，咯血停止。尽管罕见，但BAA破裂应被视为大量咯血的一个病因。由于小的BAA可能被忽视，因此在BAG中密切观察很重要。
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