Massive hemoptysis, the etiology is aorto-bronchial fistula (original) (raw)
Related papers
American Journal of Roentgenology, 2002
OBJECTIVE. We assessed the capacity of chest radiography and CT to determine the cause and site of bleeding in patients with either large or massive hemoptysis compared with bronchoscopy. MATERIALS AND METHODS. We reviewed the chest radiographs, CT scans, and bronchoscopic findings in 80 patients with either large or massive hemoptysis who were admitted to our intensive care unit between January 1995 and June 1999. RESULTS. Findings on chest radiography were normal in only 13% of patients, of whom 70% had bronchiectasis. The chest radiographs revealed the site of bleeding in 46% of the patients and the cause in 35%, most of whom had tuberculosis or tumors. CT was more efficient than bronchoscopy for identifying the cause of bleeding (77% vs 8%, respectively; p < 0.001), whereas the two methods were comparable for identifying the site of bleeding (70% vs 73%, respectively; p = not significant). CONCLUSION. These data suggest that CT could replace bronchoscopy as the first-line procedure for screening patients with large and those with massive hemoptysis. However, these results must be confirmed in a prospective multicenter study.
Evaluation of massive hemoptysis with high suspicion for alveolar hemorrhage in the emergency room
IP Indian Journal of Immunology and Respiratory Medicine
Diffuse alveolar hemorrhage is a serious life threatening condition that has to be promptly addressed during early period of presentation to emergency room. It is usually associated with some underlying causative factor. Early identification of causative factors will help in early initiation of definitive management, thereby reducing the mortality and improving the outcome. We report a case of 64-year-old male with hemoptysis who has been identified as alveolar hemorrhage in emergency room. We also evaluated its possible causative factor by clinical suspicion, laboratory investigations and contrast enhanced computed tomography imaging. Patient started showing improvement with the initiation of face mask oxygenation, empirical IV antibiotics and IV steroid which was further augmented with bronchoscopic intervention by the pulmonology team. Flexible bronchoscopy played both a diagnostic and therapeutic role in this patient. A patient presenting to emergency room with clinical triad of...
Eurasian Journal of Pulmonology, 2022
BACKGROUND AND AIM: The aim of this study is to evaluate the etiology, length of stay, treatment modality and treatment success in patients who underwent bronchoscopy due to massive hemoptysis. METHODS: The study is a cross-sectional study and was carried out with 148 patients who were transferred to our center with the complaint of massive hemoptysis between January 1, 2018 and January 1, 2021. RESULTS: The average age of the study group is 55.64±17.54. 71.6% of the patients in the study group were male. Etiological causes of patients with massive hemoptysis who underwent bronchoscopy were determined as bronchiectasis, lung cancer, tuberculosis, arterio-venous malformation and aspergilloma, respectively. The patients underwent 64.9% bronchial artery embolization (BAE), 29.7% medical treatment and 5.4% surgical treatment. The average length of stay in the intensive care unit is 4.66 days, while the length of stay in the service is 3.51 days. Relapse was seen in 9.45% of patients after BAE. The mean time to recurrence was 137.28 days. It was determined that hemoptysis recurred under 90 days in 8 cases and over 90 days in 6 cases. The success rate of BAE treatment was 90.55% and no mortal complications were observed. CONCLUSIONS: Massive hemoptysis is a life-threatening and urgent condition. Maintaining airway patency and controlling bleeding is a priority. We think that the patient should be hospitalized and followed up in the intensive care unit, contrast-enhanced thorax computed tomography and bronchoscopy should be performed in the rapid diagnosis process, BAE should be preferred first in the treatment, and surgical and other treatments should be applied if necessary.
Hemoptysis: Comparison of Diagnostic Accuracy of Multi Detector CT Scan and Bronchoscopy
Global Journal of Health Science, 2014
Background: Hemoptysis is the expectorating of blood from the tracheobronchial tree or pulmonary parenchyma. There is conflicting information about usefulness of radiography, MDCT, and bronchoscopy for investigating site and cause of the bleeding in patients with hemoptysis. The present study attempted to evaluated efficacy of these methods for identifying hemoptysis' cause and etiology on 40 patients with the disease.
Morphologic spectrum of undetermined causes of hemoptysis- a pathologistÂ’s role
Turkish Journal of Pathology, 2020
Objective: Hemoptysis is the expectoration of blood or blood-streaked sputum from the tracheobronchial tree. The etiology may derive from nonneoplastic conditions such as infections, chronic pulmonary diseases, and vasculitis or neoplastic causes. Sometimes a definitive cause for hemoptysis cannot be found after ample diagnostic workup. The role of biopsy in such cases is to help the clinician in arriving at the final diagnosis. Diffuse alveolar hemorrhage is the main histopathological finding in hemoptysis and it appears with diffuse chest infiltrates radiologically. Material and Method: A retrospective study of 2 years duration was conducted to identify the morphological spectrum of diseases presenting with hemoptysis. A total of 243 lung biopsies obtained by various methods were retrieved in this study period and 20 cases with hemoptysis of undetermined etiology were detected. Results: Based on imaging and histopathology findings, the etiological causes of hemoptysis were divided into hemoptysis with and without capillaritis or due to tumor/tumor-like lesions and due to miscellaneous conditions. The most common etiology was vasculitis followed by infections. Conclusion: Histopathology helps to detect the etiology, particularly in cases of hemoptysis due to non-immunologic causes. In immunologic cases, histopathological findings may support the diagnosis in correlation with the clinical/imaging features.
To assess the role fiberoptic bronchoscopy in the evaluation of hemoptysis
International Journal of Research in Medical Sciences, 2016
Background: To prospectively evaluate the efficiency of the fiberoptic bronchoscopy (FOB) examination in the evaluation of patients with hemoptysis. Methods: We prospectively reviewed 50 patients who underwent FOB for hemoptysis. There were 39 male and 11 female. The mean age was 46 years with a range from 21 to 83 years. The patients were divided between two groups on the basis of their chest roentograms (46% with normal and 54% with abnormal findings). Results: Hemoptysis in normal and abnormal chest roentograms was respectively attributed to bronchiectasis in 5 (21.7%) and 3 (11.1%) cases, bronchogenic carcinoma in 2 (8.6%) and 9 (33.3%) cases, bronchitis in 2 (8.6%) and 3 (11.1%) cases, tuberculosis in 2 (8.6%) and 5 (18.5%) cases, cryptogenic causes in 8 (34.7%) and 4 (14.8%) cases and pseudohemoptysis in 2 (8.6%) cases (bleeding from upper respiratory tract). Conclusions: Fob plays a pivotal role in the evaluation of hemoptysis. It was found that left upper lobe followed by right upper lobe was the site most consistent with the findings, with bronchogenic carcinoma being the most common non-infectious cause. Infectious etiology was the most common pathology behind hemoptysis and bronchiectasis was the most important risk factor.
Evaluate the patients of hemoptysis with apparently normal chest x-ray by various modalities
2016
Introduction: Hemoptysis is defined as expectoration of blood that originates from tracheo-bronchial tree or pulmonary parenchyma (lower respiratory tract) and mostly bronchial artery is responsible. A large number of patients presenting hemoptysis with normal chest radiographs may have serious underlying disorders. In such patients we required CT scanning with contrast and High resolution and fiber-optic bronchoscopy. Materials and methods: A total 50 patients had been registered OPD/IPD for study, patients had hemoptysis with apparently normal x-ray chest and patients exclude with having pseudo hemoptysis, spurious hemoptysis, hemtemesis. Sputum for AFB and gram staining, pyogenic culture sensitivity (if needed), Sputum for fungal smear (if needed), Routine Blood examination, Blood biochemistry, Mantaux Test, HRCT. FOB, ECG, if needed 2D ECHO. Results: In the present study a definite diagnosis was made in 37 patients (74%). The diagnosis was made by HRCT, broncheactisis in 26(52%)...
Diagnosis and management of hemoptysis
REVIEW ABSTRACT Hemoptysis is the expectoration of blood that originates from the lower respiratory tract. It is usually a self-limiting event but in fewer than 5% of cases it may be massive, representing a life-threatening condition that warrants urgent investigations and treatment. This article aims to provide a comprehensive literature review on hemoptysis, analyzing its causes and pathophysiologic mechanisms, and providing details about anatomy and imaging of systemic bronchial and nonbronchial arteries responsible for hemoptysis. Strengths and limits of chest radiography, bronchoscopy, multidetector computed tomography (MDCT), MDCT angiography and digital subtraction angiography to assess the cause and lead the treatment of hemoptysis were reported, with particular emphasis on MDCT angiography. Treatment options for recurrent or massive hemoptysis were summarized, highlighting the predominant role of bronchial artery embolization. Finally, a guide was proposed for managing massive and non-massive hemoptysis, according to the most recent medical literature.
Moderate hemoptysis of unknown etiology
Pediatric Pulmonology, 1999
The underlying cause and treatment of hemoptysis should be addressed promptly to avoid potentially life-threatening complications. We report on a previously healthy 11-year-old white boy who presented with acute hemoptysis. On bronchoscopy, bleeding was noted from the right upper and lower lobes. Right bronchial arteriography revealed multiple regions of abnormal ''blushing'' throughout the right bronchial arterial distribution which was successfully controlled by right bronchial arterial embolization. In spite of an extensive work-up, we were not able to determine the cause of bleeding. The patient has been followed for 18 months without any recurrence and without evidence of any systemic disease. Our patient does not fit any diagnostic category of pulmonary bleeding and further case reports are needed to delineate this entity.
Analysis of patients with hemoptysis in a reference hospital for chest diseases
Tuberkuloz ve toraks, 2006
Chest physicians frequently come across with the symptom hemoptysis, an alerting symptom which may result from a wide variety of disorders. In this study, we aimed to determine the main causes of hemoptysis in a reference hospital for chest diseases. All the patients who admitted to our emergency clinic with hemoptysis during three months of study period were included in the study. The mean age of 143 patients (106 males, 37 females) who were included in this study was 48 +/- 17 years. Medical history, physical examination and chest radiography were performed for each patient. Sputum examination for acid fast bacilli, computed tomography of thorax, fiberoptic bronchoscopy, ventilation-perfusion scintigraphy, echocardiography, ear-nose-throat examination and upper gastrointestinal system endoscopy were the further diagnostic investigations for selected patients. Bronchiectasis was the most common cause of hemoptysis (22.4%), followed by lung cancer (18.9%), active tuberculosis (11.2%...