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A ruptured bronchial artery aneurysm with massive haemoptysis
Ryoma Ueda1, Yuki Kotani1, Toshihide Tsujimoto1
1Critical Care Medicine, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan.
BMJ Case Reports
|May 25, 2017
Summary
A rare 3mm ruptured bronchial artery aneurysm (BAA) caused massive, life-threatening bleeding. Prompt bronchial artery embolisation successfully stopped the hemorrhage, highlighting the importance of considering small BAAs in massive haemoptysis cases.
Area of Science:
- Cardiology
- Radiology
- Pulmonology
Background:
- Massive haemoptysis presents a significant mortality risk.
- Ruptured bronchial artery aneurysms (BAAs) are an uncommon cause of massive haemoptysis.
Observation:
- A previously healthy 77-year-old woman presented with sudden, massive haemoptysis.
- Initial CT scans and bronchoscopies failed to identify the bleeding source.
- Repeated bronchial arteriography (BAG) eventually detected a small, 3mm ruptured BAA with a bleb.
Findings:
- Successful diagnosis of a ruptured BAA, despite its small size.
- Bronchial artery embolisation effectively ceased the massive haemoptysis.
Implications:
- Ruptured BAAs, even small ones, must be considered in the differential diagnosis of massive haemoptysis.
- Close observation during BAG is crucial to avoid overlooking small BAAs.
- Early diagnosis and intervention via embolisation can be life-saving.
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