1/20. Fatal haemorrhage from Dieulafoy's disease of the bronchus.A 70 year old woman with a previous history of healed tuberculosis and suspected chronic obstructive pulmonary disease presented with recurrent haemoptysis and respiratory failure from a lobar pneumonia. Massive bleeding occurred when biopsy specimens were taken during bronchoscopy which was managed conservatively, but later there was a fatal rebleed from the same site. Two different Dieulafoy's vascular malformations were found in the bronchial tree at necropsy, one of which was the biopsied lesion in the left upper lobe. This report confirms the possibility that vascular lesions occur in the bronchial tree. It is suggested that, if such lesions are suspected at bronchoscopy, bronchial and pulmonary arteriography with possible embolotherapy should be performed.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/20. Pulmonary sequestration diagnosed by contrast enhanced three-dimensional MR angiography.Pulmonary sequestration is a congenital bronchopulmonary foregut malformation in which a segment of lung parenchyma is not connected to the tracheobronchial tree. This abnormal segment receives a blood supply from the systemic circulation. Multiple imaging modalities have been used to demonstrate the vascular anatomy of the sequestration. Different magnetic resonance angiography (MRA) techniques have been employed in the identification of these anomalous vessels. We report a case of pulmonary sequestration diagnosed by MRI with the use of contrast enhanced three-dimensional MRA.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
3/20. Late development of aortic pseudoaneurysm after coarctation repair with fistulization to the bronchial tree. A case report.BACKGROUND: Fistulous communication between the aorta and the tracheobronchial tree is an uncommon and serious cause of hemoptysis secondary to complications of a previous operation performed on the aorta. In cases in which an appropriate surgical intervention is carried out, the survival rate approaches 76%. This surgery is considered one of the most risky operations on the aorta, challenging the surgeon's ability to resolve the problem. methods: We present the case report of a 43-year-old female with massive hemoptysis. Her medical history disclosed repair of coarctation of the aorta (15 years before). She underwent emergency left thoracotomy; surgical exploration revealed a false aneurysm from the previous aortic patch repair which communicated to a subsegmental bronchus of the left upper lobe. RESULTS: The thoracic aorta was isolated and clamped, and the previous patch was removed. The bronchial side of the fistula was managed with left superior lobectomy and the aorta was repaired with the placement of a coated woven dacron graft onto healthy aortic tissue. CONCLUSIONS: The patient had an uneventful recovery and remains asymptomatic six months after discharge.- - - - - - - - - - ranking = 2.5keywords = tree (Clic here for more details about this article) |
4/20. hemoptysis as an unusual presenting symptom of invasion of a descending thoracic aortic aneurysmal dissection by lung cancer.A 70-year-old woman with a known chronic dissecting aneurysm of the descending thoracic aorta presented with new-onset back pain and hemoptysis. The hemoptysis was thought to be the result of invasion of the bronchial tree by the aneurysm. During surgical repair, a lesion that appeared to be a pulmonary abscess was discovered to be adhering to the aortic tissue, and the patient underwent a localized pulmonary resection. The pathology report of the surgical specimens revealed squamous cell carcinoma of the lung with infiltration of the aortic wall. The patient died of lung cancer 6 months later. hemoptysis was an unusual presentation in a case of lung cancer that had invaded a stable chronic aortic aneurysm.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
5/20. Active pulmonary hemorrhage localized by selective pulmonary angiography.Massive hemoptysis in a young woman with negative chest film findings is presented. By using selective pulmonary artery angiography during active pulmonary bleeding, the following findings were demonstrated: (1) intraparenchymal hemorrhage, (2) clearing of blood from the lung and bronchial tree by coughing, (3) early filling of the inferior pulmonary vein. Following lobectomy, specimen angiography suggests the presence of a small arteriovenous fistula. This experience demonstrates that selective pulmonary arteriography may be a useful adjunct in the management of selected patients with massive hemoptysis of obscure etiology.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
6/20. Haemoptysis as a late complication of a Mustard operation treated by balloon dilation of a superior caval venous obstruction.Haemoptysis was the presenting symptom in a 27-year-old male. He had undergone a Mustard operation for connection of complete transposition at the age of 2 years. For 6 months prior to admission, he had complained of dyspnoea without chestpain, and swelling of the fingers during hard physical work. Chest radiography and computer tomographic scans showed normal features of the pulmonary parenchyma, and no sign of cardiomegaly or vascular stasis. Fiberoptic bronchoscopy demonstrated a blood clot in the upper right bronchus, without any associated abnormalities of the bronchial tree. Doppler echocardiography showed obstruction of the superior caval vein, which was verified by cardiac catheterization. Balloon dilation at the site of obstruction increased the diameter of the vein from 0.5 to 1.7 cm, and the mean pressure in the superior caval vein was reduced significantly from 18 to 10 mmHg. The haemoptysis did not recur, and no complaints of dyspnoea or swelling of fingers during physical activity was reported 2 years later. Transthoracic echocardiography undertaken at this time revealed no obstruction of the superior caval vein. We conclude that hemoptysis is a rare complication of increased venous pressure in the upper body of patients with superior caval venous obstruction, which can be treated by balloon dilation or stenting.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
7/20. Massive hemoptysis caused by tracheal hemangioma treated with interventional radiology.Capillary hemangiomas of the tracheobronchial tree are extremely rare in adults, with hemoptysis being one of the most serious forms of presentation. An operation has been the treatment of choice, although it does involve high rates of morbidity and mortality, especially in emergency situations such as massive hemoptysis, which has led to the search for other therapeutic alternatives. There is no experience with embolization by interventional radiology when the hemoptysis is tracheal in origin, caused partly because the infrequency of this pathology; however, the foundations for it have been laid with the development of embolization for bronchopulmonary pathology. We report a case of a tracheal capillary hemangioma in a 66-year-old woman diagnosed with idiopathic thrombopenic purpura, which began as a massive hemoptysis and was treated successfully with embolization by interventional radiology. There has been no recurrence of the bleeding after 1 year's follow-up, and the patient's control fibrobronchoscopy is normal.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
8/20. A case report of congenital isolated absence of the right pulmonary artery: bronchofibrescopic findings and chest radiological tracings over 9 years.A 27-year-old man was admitted to hospital for investigation of haemoptysis. He was a serving member of the japan Self-Defense Forces. A CXR showed absence of the right hilum, and the right hemithorax was smaller than the contralateral hemithorax. Pulmonary arteriography demonstrated complete absence of the right pulmonary artery. Right heart catheterisation did not show any concomitant cardiovascular malformations, and the patient was diagnosed as having isolated absence of the right pulmonary artery. Bronchial arteriograms demonstrated enlargement and proliferation of the small branches of the right bronchial artery. Bronchofibrescopic examination showed obvious enlargement of the bronchial mucosal vessels with submucosal eruptions and swelling in the right bronchial tree, but not on the left side. Re-examination of the patient's CXR from the previous 9 years revealed a chronological decrease of right lung volume and an increase of the cardiothoracic ratio. Isolated absence of the right pulmonary artery is generally considered to have a good prognosis, but close observation is necessary to monitor the pulmonary haemodynamics.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
9/20. Transcatheter bronchial artery embolization in the multimodality management of massive hemoptysis.To illustrate the potential role of transcatheter bronchial artery embolization (TBAE) in the multimodality management of massive hemoptysis, we describe a case in which TBAE was successfully employed as the definitive therapy. In recent years, the technique of TBAE has joined the armamentarium of managing methods for massive hemoptysis. While massive hemoptysis has traditionally been defined in terms of the volume of blood produced within a period of time, with a rate of 600 ml in 24 hours the most commonly used definition, a more functional definition has been proposed: bleeding into the tracheobronchial tree at a rate that poses a threat to life. It is the life-threatening nature of this symptom that often results in the early involvement of thoracic surgeons in the care of these patients.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
10/20. Nosocomial pulmonary mucormycosis with fatal massive hemoptysis.We postulate that the previously healthy woman reported here developed abnormal host defense mechanisms because of acute renal failure, metabolic acidosis, hyperglycemia, and glucocorticosteroid administration. pneumonia unresponsive to antibiotics terminated in massive fatal hemoptysis that was due to mucormycosis with rupture of the pulmonary artery into the tracheobronchial tree.- - - - - - - - - - ranking = 0.5keywords = tree (Clic here for more details about this article) |
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