一例罕见的咯血病例：肺脓肿继发肺动脉假性动脉瘤。
An unusual case of hemoptysis: Pulmonary artery pseudoaneurysm secondary to a lung abscess.
作者信息
Tanaka Hiroyuki, Uraki Junji, Tanigawa Motoaki, Nakanishi Yuki, Toyoshima Hirokazu, Sakabe Shigetoshi
机构信息
Department of Infectious Diseases, Japanese Red Cross Ise Hospital, 471-2, Funae, Ise, Mie, 516-8512, Japan.
Department of Radiology, Japanese Red Cross Ise Hospital, 471-2, Funae, Ise, Mie, 516-8512, Japan.
出版信息
Respir Med Case Rep. 2021 Sep 3;34:101508. doi: 10.1016/j.rmcr.2021.101508. eCollection 2021.
Massive hemoptysis may originate from injured pulmonary arteries, such as from pulmonary artery pseudoaneurysms (PAPs). A 93-year-old man, diagnosed with pneumonia, was hospitalized; he later developed a lung abscess (controlled with intravenous antibiotics). On post-hospitalization day 29, he suddenly developed hemoptysis. Multi-detector computed tomography angiography (MDCTA) showed an enhanced nodule, diagnosed as a PAP, inside the lung abscess. The hemoptysis resolved, without recurrence, following transcatheter arterial embolization (TAE) of the PAP and its feeding arteries. PAPs should be considered in patients with lung abscesses and delayed massive hemoptysis. In these patients, MDCTA and TAE are effective diagnostic and treatment modalities.
大量咯血可能源于受损的肺动脉，比如源于肺动脉假性动脉瘤（PAPs）。一名93岁男性，诊断为肺炎后住院；随后发展为肺脓肿（通过静脉使用抗生素控制）。在住院第29天，他突然出现咯血。多排螺旋计算机断层血管造影（MDCTA）显示肺脓肿内有一个强化结节，诊断为PAP。对PAP及其供血动脉进行经导管动脉栓塞术（TAE）后，咯血停止，未再复发。对于患有肺脓肿且出现延迟性大量咯血的患者，应考虑PAPs。在这些患者中，MDCTA和TAE是有效的诊断和治疗方式。
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