Myriad Faces of Active Tuberculosis: Intrapulmonary Bronchial Artery Pseudoaneurysm

2021 ◽  
pp. 153857442110518
Author(s):  
Kavirajan Kabilan ◽  
Malvika Gulati ◽  
Irshad A. Banday ◽  
Rahul Tyagi ◽  
Ashu Seith Bhalla ◽  
...  
Keyword(s):  
Bronchial Artery ◽  
Young Male ◽  
Vascular Complication ◽  
Lung Abscess ◽  
Massive Hemoptysis ◽  
Bronchial Arteries ◽  
Artery Pseudoaneurysm ◽  
Pulmonary Tb ◽  
Risk Of Rupture ◽  
Life Threatening

Bronchial artery (BA) pseudoaneurysm is an uncommon vascular complication of tuberculosis (TB), and early diagnosis is crucial due to risk of rupture and life-threatening hemorrhage. Immediate intervention is warranted in massive hemoptysis due to high mortality. Various causes of massive hemoptysis are TB, bronchiectasis, aspergilloma, lung abscess, lung cancer, necrotizing pneumonia, and cystic fibrosis. Active pulmonary TB as well as chronic pulmonary TB can manifest with massive hemoptysis. Hemoptysis in active TB occurs due to ulceration in bronchiolar wall, eroding the wall of the adjacent BA or pulmonary artery, and in chronic TB due to hypertrophied bronchial arteries, or bronchiectasis, or aspergilloma. Herein, we report a case of pulmonary TB causing intrapulmonary BA pseudoaneurysm in a young male patient who presented with acute massive hemoptysis. The BA pseudoaneurysm as well as other hypertrophied bronchial arteries were embolized using polyvinyl alcohol (PVA) particles.

scholarly journals A Rare Cause of Hemoptysis in Children; Bronchial Artery to Pulmonary Artery Fistula in Healthy Child

2021 ◽  
pp. 1-4
Author(s):  
Nader Francis ◽  
◽  
Ahmad Al Kamali ◽  
Sinan Yavuz ◽  
◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Healthy Child ◽  
Bronchial Artery ◽  
Artery Aneurysm ◽  
Normal Lung ◽  
Massive Hemoptysis ◽  
Pediatric Age Group ◽  
Risk Of Rupture ◽  
Life Threatening ◽  
Pulmonary Artery Fistula

Hemoptysis is a rare, life-threatening condition in childhood defined as bleeding into the lungs due to underlying disorders or respiratory tract abnormalities. The bleeding from an arterial malformation to normal lung segments without underlying cardiovascular or pulmonary disorders is widely reported in adults but extremely rare in the pediatric age group. Bronchial artery aneurysm (BAA) is a rare vascular malformation complicated with a bronchial artery to pulmonary artery (BA PA) fistula. BAAs are life-threatening conditions because of the substantial risk of rupture that can cause massive hemoptysis. In such a case, BAA embolization (BAAE) has become essential management. We report here previously healthy child presented with massive hemoptysis due to systemic-pulmonary fistula, which was bleeding controlled by BAAE

Control of Tubercular Haemoptysis by Bronchial Artery Embolization

1997 ◽  
Vol 27 (3) ◽  
pp. 149-150 ◽  
Author(s):  
Sanjeev Mani ◽  
Rajesh Mayekar ◽  
Ravi Rananavare ◽  
Deepti Maniar ◽  
J Mathews Joseph ◽  
...  
Keyword(s):  
Bronchial Artery ◽  
Bronchial Artery Embolization ◽  
Artery Embolization ◽  
Selective Embolization ◽  
Bronchial Arteries ◽  
Bleeding Vessel ◽  
Life Threatening ◽  
Abnormal Bleeding ◽  
Recurrent Haemoptysis

Thirty-seven patients presenting with massive or recurrent haemoptysis secondary to tuberculous aetiology were subjected to bronchial artery angiography. Of these, failure to catheterize the bleeding vessel occurred in two patients while embolization was withheld in two patients due to the presence of anterior spinal artery arising from a common intercosto-bronchial trunk. Immediate arrest of bleeding was performed in the remaining 33 patients by selective embolization of the abnormal bronchial arteries with a resorbable material (Gelfoam). Regular follow up for a duration of 6 months after the procedure revealed relapse of haemoptysis in four patients; three were treated by re-embolization of the abnormal bleeding vessels while one patient died due to aspiration immediately on admission. No recurrence of bleeding was seen in the remaining 29 patients. It is concluded that bronchial artery embolization is an effective treatment for immediate control of life-threatening haemoptysis.

Life-Threatening Hemoptysis

2020 ◽  
Author(s):  
Himanshu Deshwal ◽  
Ankur Sinha ◽  
Atul C. Mehta
Keyword(s):  
Bronchial Artery ◽  
Vascular Anatomy ◽  
Massive Hemoptysis ◽  
Evidence Based ◽  
Airway Protection ◽  
Artery Embolization ◽  
Life Saving ◽  
Advanced Therapies ◽  
Life Threatening ◽  
And Control

AbstractLife-threatening hemoptysis (LTH) is any amount of hemoptysis that causes significant hemodynamic decompensation or respiratory distress which may lead to death if left untreated. While the amount of hemoptysis that qualifies as massive hemoptysis has continued to be debated, any amount between 100 to 1,000 mL/day is considered significant. Up to 15% cases of hemoptysis are LTH and need urgent life-saving intervention. Understanding of pulmonary vascular anatomy is of paramount importance to manage LTH. The goal of treatment lies in airway protection, appropriate oxygenation, and prevention of exsanguination. Once the airway is stabilized, a quick diagnosis and control of bleeding site is targeted. This chapter highlights current practices and approach to LTH including medical management, bronchoscopic approach, and advanced therapies such as bronchial artery embolization and surgical resection. We review situations, such as bronchiectasis, vascular malformation, diffuse alveolar hemorrhage, and tracheostomy bleed and specific approach to management of these conditions in a systematic and evidence-based manner.

scholarly journals Rasmussen’s Aneurysm, Rare yet Acknowledged Cause of Massive Hemoptysis: Retrospective Review of 16 Cases

2021 ◽  
Vol 36 (2) ◽  
pp. 136-143
Author(s):  
Seungwoo Chung ◽  
I Re Heo ◽  
Tae Hoon Kim ◽  
Sun Mi Ju ◽  
Jung-Wan Yoo ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Conservative Therapy ◽  
Bronchial Artery ◽  
Chest Ct ◽  
Massive Hemoptysis ◽  
Bronchial Artery Embolization ◽  
Artery Embolization ◽  
Chest Computed Tomography ◽  
Life Threatening ◽  
History Of

Objectives: Rasmussen’s aneurysm may cause life-threatening hemoptysis. We investigated the clinical characteristics and outcomes of patients with hemoptysis and Rasmussen’s aneurysm.Methods: We retrospectively investigated patients who clinically presented with hemoptysis and were diagnosed with a Rasmussen’s aneurysm on spiral chest computed tomography (CT).Results: Our study included 16 patients (men:women, 12:4; mean age, 65.25 ± 13.0 years). Massive hemoptysis was observed in nine patients (56%) and blood-tinged sputum in four patients (25%). Ten patients (62.5%) had a history of pulmonary tuberculosis, and three patients (18.7%) had underlying lung cancer. Chest CT revealed coexisting fungal balls in seven patients (43.7%). Bronchial artery embolization (BAE) was performed in 12 patients (75%). One patient died of uncontrolled massive hemoptysis.Conclusions: Patients with Rasmussen’s aneurysm showed hemoptysis during the course of the disease; however, bleeding can be controlled with conservative therapy and radiological interventions, such as BAE.

scholarly journals Massive Pulmonary Hemorrhage from Bronchial Varix

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Michael Agustin ◽  
Scott Shay ◽  
Jose Gonzalez ◽  
Pei Liu ◽  
Nancy Lentz ◽  
...  
Keyword(s):  
Bronchial Artery ◽  
Pulmonary Hemorrhage ◽  
Lung Ventilation ◽  
Massive Hemoptysis ◽  
Sleeve Resection ◽  
Artery Embolization ◽  
Blood Clots ◽  
Pulmonary Disorder ◽  
Life Threatening ◽  
Definitive Management

Bronchial varix is a rare pulmonary disorder which may lead to life-threatening hemorrhage. Diagnosis is difficult because of the subtle abnormalities on radiographic and bronchoscopic examination. We present a case of massive hemoptysis from a bleeding bronchial varix. In the absence of immediate complex endobronchial therapy in the island of Guam, this case was initially managed with nebulized and intravenous tranexamic acid. This was followed by endobronchial blockade of the bleeding airway with endobronchial epinephrine instillation. Selective bronchial artery embolization alleviated the acute-phase bleeding. Prone positioning was initiated due to severe hypoxia after blood clots compromised the patency of bilateral bronchial airways. Prone ventilation was employed for 17 hours for 2 consecutive days with intermittent bronchoscopic forceps extraction of airway blood clots while in the prone position. These maneuvers resulted to improved lung ventilation and oxygenation. The patient underwent bronchial sleeve resection surgery for definitive management.

The Role of Sonography in a Rare Case of Hepatic Artery Pseudoaneurysm: A Case Study Report

2021 ◽  
pp. 875647932110189
Author(s):  
Nadia M. Chupka ◽  
Thomas D. Atwell ◽  
Ian R. McPhail ◽  
Talisha M. Hunt
Keyword(s):  
Hepatic Artery ◽  
Imaging Modality ◽  
Liver Trauma ◽  
Artery Pseudoaneurysm ◽  
Risk Of Rupture ◽  
Case Study Report ◽  
Inflammatory Processes ◽  
Life Threatening

Hepatic artery pseudoaneurysms (HAPs) are rare, life-threatening complications that arise in response to liver trauma or underlying inflammatory processes. The risk of rupture necessitates prompt diagnosis and treatment. Sonography is an important imaging modality used to evaluate and characterize suspected HAPs. In the case described below, sonography played an important role in the diagnosis and successful treatment of a patient with a large, high-risk HAP.

scholarly journals Successful Surgical Resection following Bronchial Artery Embolization in a Case of Lung Cancer Complicated with Massive Hemoptysis

2018 ◽  
Vol 11 (1) ◽  
pp. 125-130 ◽  
Author(s):  
Hironori Sadamatsu ◽  
Koichiro Takahashi ◽  
Hiroshi Inoue ◽  
Hitomi Umeguchi ◽  
Satoko Koga ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Surgical Resection ◽  
Bronchial Artery ◽  
Treatment Options ◽  
Massive Hemoptysis ◽  
Bronchial Artery Embolization ◽  
Artery Embolization ◽  
Lung Cancer Patients ◽  
Resected Tumor ◽  
Life Threatening

Hemoptysis is sometimes observed in lung cancer patients and can be life-threatening. We present a case with severe hemoptysis that was resolved by bronchial artery embolization (BAE) followed by surgery. The presence of necrotic tissue in the majority of the resected tumor and only few cancer cells was presumed to be from loss of bronchial artery blood flow. Although BAE is not a standard therapy for lung cancer, it can be useful and may be considered by physicians as one of the treatment options prior to surgical resection in cases with hemoptysis.

scholarly journals Life-threatening hemoptysis accompanied by internal thoracic artery aneurysms in a 28-year-old perinatal woman: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yujun Li ◽  
Yuyao Wang ◽  
Zhike Liang ◽  
Chuzhi Pan ◽  
Xiaomei Huang ◽  
...  
Keyword(s):  
Internal Thoracic Artery ◽  
Bronchial Artery ◽  
Main Bronchus ◽  
Treatment Options ◽  
Perinatal Period ◽  
Bronchial Arteries ◽  
Superior Mediastinum ◽  
Active Hemorrhage ◽  
Life Threatening ◽  
The Right

Abstract Background Life-threatening hemoptysis presents an immediate diagnostic and therapeutic challenge, especially during the perinatal period. Case presentation A 28-year-old perinatal woman with no significant past medical or surgical history presented with repeating hemoptysis and respiratory failure. Computed tomography revealed a 2.1 × 3.2  cm2 inhomogeneous tumorous lesion in the right superior mediastinum and a right main bronchus obstruction along with atelectasis of the right lung. Bronchoscopy showed a tumorous protrusion blocking the right main bronchus with active hemorrhage, and malignancy was suspected. Bronchial artery embolization (BAE) was performed to control the bleeding. The arteriogram revealed tortuosity, dilation and hypertrophy of the right bronchial arteries and aneurysms of the internal thoracic artery (ITA). The bleeding completely stopped after BAE. Bronchoscopy was performed again to remove residual blood clots. The patient recovered soon after the procedure and was discharged. Conclusions Life-threatening hemoptysis concomitant with ITA aneurysms, which may have a misleading clinical diagnosis and treatment options, has not been reported previously in perinatal women. BAE could be used as a first-line treatment irrespective of the underlying causes.

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