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急症肺切除术治疗支气管畸形引起的大咯血

Emergent Lung Resection for Massive Hemoptysis From Bronchial Malformation.

机构信息

Department of Surgery, Washington University School of Medicine, St Louis, Missouri.

Department of Surgery, Washington University School of Medicine, St Louis, Missouri.

出版信息

Ann Thorac Surg. 2021 Dec;112(6):e423-e426. doi: 10.1016/j.athoracsur.2021.02.044. Epub 2021 Mar 4.

Abstract

Bronchial arteriovenous malformations are usually asymptomatic findings noted on imaging but may present with massive hemoptysis after endobronchial rupture. Initial treatment usually involves transcatheter embolization with surgery reserved for refractory cases. Here, we present a patient with large-volume hemoptysis after bronchial arteriovenous malformation rupture. Attempted endovascular management was unsuccessful owing to unfavorable anatomy and hemodynamic instability, necessitating emergent use of extracorporeal membrane oxygenation followed by right bilobectomy.

摘要

支气管动静脉畸形通常在影像学检查时无症状,但在支气管破裂后可能出现大量咯血。初始治疗通常采用经导管栓塞,手术保留为难治性病例。在此,我们介绍一例支气管动静脉畸形破裂后大咯血患者。由于解剖结构不利和血流动力学不稳定,血管内治疗尝试失败,需要紧急使用体外膜氧合,随后行右肺叶切除术。

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