Ueda Ryoma, Kotani Yuki, Tsujimoto Toshihide
Critical Care Medicine, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan.
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。
