[Therapeutic guide line for hemoptysis]

We report the result of treatment for thirty-two patients whose chief complaint was hemoptysis and represent the therapeutic guide line for hemoptysis. In thirty-two cases, there were twenty men and twelve women and average of age was fifty-two years old. Twenty-nine of them were chronic lung diseases such as tuberculosis and bronchiectasis and only three cases have malignant tumors. Two of them recovered with conservative therapy and bronchial arteriography (BAG) have been performed in thirty patients in order to determine the bleeding foci, BAG was failed in two cases, but these two cases have been recovered with following up, BAG was succeeded in twenty-eight cases and twelve cases of them could not been determined the bleeding foci by angiography and could be controlled using hemostatic and antibiotic agents. Embolization of bronchial arteries with gelatin sponge have been performed in sixteen cases and made success in eleven cases. In ten of these cases, BAE was effective less than two times. Only one of silicosis with restrictive lung function was considered contraindication of surgery and recovered by three times of BAE. Four cases of five uneffective BAE (rebleeding after two times of BAE) have been treated by operation in good course. But one case complicated with WPW syndrome has died because of aspiration pneumonia without operation. In our institute, the rate of operation for hemoptysis was low as 13% of thirty-two cases. In order to consider the indication of surgery, bronchial arteriography was essential to determine bleeding foci and BAE was effective in over 80% of hemoptysis.(ABSTRACT TRUNCATED AT 250 WORDS)