Inam Hina, Zahid Ibrahim, Khan Sarim Dawar, Haq Salman Ul, Fatimi Saulat
Cardiothoracic Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Dow University of Health Sciences, Karachi, Pakistan.
J Cardiothorac Surg. 2019 Jul 25;14(1):144. doi: 10.1186/s13019-019-0959-y.
Massive hemoptysis is a life-threatening condition and can arise as a complication of various conditions. It rarely occurs as a complication of a ruptured thoracic aortic aneurysm. Even rarer are conditions where pseudoanurysms of aorta result due to infection.
A 30 year-old female patient presented with left sided chest pain, intermittent fever, cough and massive hemoptysis. A pseudo-aneurysm of proximal descending thoracic aorta at the level of the left Subclavian artery was noted over CT scan. Upon performing a left posterolateral thoracotomy, the aneurysm was seen to have ruptured into the apical segment of left upper lobe, contained mainly by a thrombus. The anterior wall of the pseudoaneurysm was debrided and a bovine pericardial patch was used to repair the aortic defect. Cultures of the tissue obtained showed Enterobacter species, therefore the patient was prescribed 6 weeks of IV antibiotics following surgery. Post-operative CT scan revealed reduced diameter of the aorta. She was discharged in good health and remains well at follow up evaluation.
We present a case of hemoptysis caused by a ruptured descending aorta aneurysm into left lung. The aneurysm was secondary to infection by Enterobacter. Surgical repair of the concerned region of aorta was effective, without any major sequelae. To the best of our knowledge, no such cases have been reported previously.
大量咯血是一种危及生命的状况，可作为各种疾病的并发症出现。它很少作为胸主动脉瘤破裂的并发症发生。由感染导致主动脉假性动脉瘤的情况更为罕见。
一名30岁女性患者出现左侧胸痛、间歇性发热、咳嗽和大量咯血。CT扫描发现左锁骨下动脉水平的降主动脉近端假性动脉瘤。行左后外侧开胸术后，可见动脉瘤已破裂入左上叶尖段，主要由血栓包绕。切除假性动脉瘤前壁，用牛心包补片修复主动脉缺损。所取组织培养显示为肠杆菌属，因此术后给患者静脉应用抗生素6周。术后CT扫描显示主动脉直径缩小。她康复出院，随访评估情况良好。
我们报告一例降主动脉瘤破裂入左肺导致咯血的病例。该动脉瘤继发于肠杆菌感染。对主动脉相关区域进行手术修复有效，无任何严重后遗症。据我们所知，此前尚无此类病例报道。
