Kemper Nicholas W, Myers Alexander C, Thompson Hanna K, Baah Nana Ohene, Contractor Sohail
University of Louisville School of Medicine, Department of Radiology, Louisville, KY, USA.
University of Louisville School of Medicine, Louisville, KY 40202, USA.
Radiol Case Rep. 2024 May 14;19(8):3170-3175. doi: 10.1016/j.radcr.2024.04.070. eCollection 2024 Aug.
Pulmonary arteriovenous malformations, previously considered a rare condition, have been increasingly identified in asymptomatic patients over the past 2 decades. Usually congenital and associated with hereditary hemorrhagic telangiectasia, these fistulae result in right-to-left shunting of blood by abnormal communication of pulmonary arteries and veins lacking capillary beds. Clinical findings of right-to-left shunting in the presence of feeding and draining vessels identified on imaging confirm the diagnosis, for which the first-line therapy is embolization. This report highlights the presentation and management of a large asymptomatic PAVM detected incidentally in a patient who was lost to follow-up for 10 years and represented with acute hypoxic respiratory failure secondary to a viral infection with an interval increase of PAVM size.
肺动静脉畸形，以前被认为是一种罕见疾病，在过去20年中，越来越多地在无症状患者中被发现。这些瘘管通常是先天性的，与遗传性出血性毛细血管扩张症相关，由于缺乏毛细血管床的肺动脉和静脉异常连通，导致血液从右向左分流。影像学检查发现有供血和引流血管时出现右向左分流的临床特征可确诊，其一线治疗方法是栓塞。本报告重点介绍了一名患者偶然发现的大型无症状肺动静脉畸形的表现及处理情况，该患者失访10年后因病毒感染继发急性低氧性呼吸衰竭再次就诊，期间肺动静脉畸形大小有所增加。
