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Published on: April 15, 2021
Mediastinal bronchial artery aneurysm with hematemesis
A Fukunaga1, S Okushiba, K Ohno
1Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan. fuku@med.hokudai.ac.jp
Summary
Mediastinal bronchial artery aneurysms are rare but dangerous. This case highlights a rare presentation of esophageal compression and hematemesis, successfully diagnosed with advanced imaging and treated with embolization.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Diagnostic Imaging
Background:
- Mediastinal bronchial artery aneurysms are uncommon vascular malformations.
- They can cause life-threatening hemorrhage, often presenting with respiratory symptoms upon rupture.
- Posteriorly located aneurysms may compress adjacent structures like the esophagus.
Observation:
- A rare case of mediastinal bronchial artery aneurysm presented with hematemesis, mimicking an esophageal submucosal tumor.
- Initial computed tomography and endoscopic ultrasound suggested a submucosal lesion.
- Magnetic resonance imaging and probe thoracoscopy were crucial for accurate diagnosis.
Findings:
- The study successfully diagnosed a mediastinal bronchial artery aneurysm presenting atypically with esophageal compression.
- Advanced imaging techniques, including MRI, were key to differentiating the aneurysm from other esophageal pathologies.
- The patient underwent successful transluminal artery embolization for treatment.
Implications:
- This case expands the known clinical presentations of mediastinal bronchial artery aneurysms.
- It underscores the importance of considering vascular anomalies in the differential diagnosis of esophageal compression symptoms.
- Successful endovascular treatment demonstrates a minimally invasive therapeutic option for this rare condition.
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