Yu Michelle Wai Ling, Li Albert M, Lai Ming Hei, Chan Kate Ching Ching
Department of Paediatrics, Prince of Wales Hospital, Hong Kong, Hong Kong.
Faculty of Medicine, Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
BMJ Case Rep. 2023 Aug 14;16(8):e255480. doi: 10.1136/bcr-2023-255480.
Rasmussen's aneurysm is a rare yet fatal cause of massive haemoptysis in pulmonary tuberculosis. Early identification and timely intervention are of utmost importance to reduce the associated mortality. A girl in early adolescence presented with persistent fever and massive haemoptysis who required intubation and was subsequently confirmed to have tuberculosis. CT pulmonary angiogram showed the presence of pseudoaneurysms in the left upper and lower lobes. The haemoptysis resolved following the embolisation of the culprit's vessel. Residual lung destruction was evident on CT after a 12-month course of antituberculosis therapy. Rasmussen's aneurysm is a significant vascular complication of cavitary tuberculosis and needs to be considered in patients presenting with massive haemoptysis.
拉斯穆森动脉瘤是肺结核导致大量咯血的一种罕见但致命的病因。早期识别和及时干预对于降低相关死亡率至关重要。一名青春期早期女孩出现持续发热和大量咯血，需要插管，随后被确诊为肺结核。胸部CT血管造影显示左上叶和下叶存在假性动脉瘤。对责任血管进行栓塞后咯血得到缓解。经过12个月的抗结核治疗后，CT显示有明显的残留肺组织破坏。拉斯穆森动脉瘤是空洞型肺结核的一种重要血管并发症，对于出现大量咯血的患者需要考虑这一情况。
