[A case of pulmonary artery pseudoaneurysm secondary to lung abscess]

A 53-year-old man visited his family doctor complaining of chest pain and cough in January 2006. He had a 5-year history of uncontrolled diabetes mellitus. His illness was diagnosed as pneumonia of the left lingular division. Antibiotics were started but his pneumonia worsened repeatedly after insufficient antibiotics due to his poor compliance with medication. In addition to pneumonia, he began to have hemoptysis at the end of May and was admitted to our hospital. Contrast-enhanced CT scan on admission showed a lung abscess on the left lingular division and formation of a pulmonary pseudoaneurysm inside the abscess. Treatment with SBT/ABPC rapidly improved his condition but massive hemoptysis recurred 9 days after admission. Embolization of the bronchial artery and pulmonary pseudoaneurysm successfully controlled airway bleeding. When hemoptysis occurs due to sustained inflammation such as a lung abscess, bleeding from the pulmonary artery should be considered and a precise evaluation including contrast-enhanced CT and pulmonary angiography made.