Fukumura Y, Watanabe M, Katayama K, Shimoe Y, Yoshida O, Kurokami K
Department of Surgery, Tokushima Prefectural Central Hospital, Japan.
Kyobu Geka. 1995 Nov;48(12):1046-9.
A 76-year-old man was admitted for recurrent hemoptysis of 3 weeks' duration. Chest X-ray revealed lung emphysema, but no findings of thoracic aortic aneurysm. The patient's physician attributed to bronchoectasia, and he underwent angiography for the purpose of embolization of bronchial arteries. Angiography showed a small saccular thoracic descending aortic aneurysm and an aortopulmonary fistula. So aneurysmectomy and patch angioplasty was done under partial cardiopulmonary bypass. Lobectomy or wedge pulmonary resection was not necessary. His postoperative course was uneventful. In case of the patients with hemoptysis, the possibility of aortopulmonary fistula should be considered, and computed tomography or aortography should be done to rule out other pulmonary diseases.
一名76岁男性因持续3周的反复咯血入院。胸部X线显示肺气肿，但未发现胸主动脉瘤。患者的医生认为是支气管扩张，遂为其进行支气管动脉栓塞造影。造影显示一个小的囊状胸降主动脉瘤和一个主肺动脉瘘。于是在部分体外循环下进行了动脉瘤切除术和补片血管成形术。无需进行肺叶切除术或楔形肺切除术。他术后恢复顺利。对于咯血患者，应考虑主肺动脉瘘的可能性，并应进行计算机断层扫描或主动脉造影以排除其他肺部疾病。
