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Traumatic Pulmonary Arteriovenous Malformation Presenting as Spontaneous Hemothorax
Obteene Azimi-Ghomi1, Marcela Ramirez1, Dieter Brummund1
1Department of General Surgery, Kendall Regional Medical Center, Miami, USA.
Cureus
|August 4, 2021
Summary
Pulmonary arteriovenous malformations (PAVMs) are rare abnormal vascular connections. This case highlights a PAVM developing a year after thoracic trauma, leading to hemothorax and requiring surgical intervention.
Area of Science:
- Vascular Surgery
- Cardiology
- Trauma Surgery
Background:
- Pulmonary arteriovenous malformations (PAVMs) are abnormal connections between pulmonary arteries and veins.
- Most PAVMs are associated with hereditary hemorrhagic telangiectasia (HHT).
- Traumatic PAVMs are exceptionally rare, accounting for less than 1% of cases.
Observation:
- A patient developed a PAVM one year after blunt thoracic trauma and a rib fracture.
- The PAVM ruptured, causing a spontaneous hemothorax requiring transfusion and chest tubes.
- Initial angioembolization was unsuccessful.
Findings:
- The case illustrates a delayed presentation of traumatic PAVM.
- Rupture of traumatic PAVMs can lead to severe, life-threatening hemorrhage.
- Surgical excision via thoracotomy was ultimately required for definitive treatment.
Implications:
- Trauma should be considered in the etiology of PAVMs, even with delayed presentation.
- Prompt diagnosis and management are crucial for patients with traumatic PAVMs.
- This case underscores the importance of considering surgical options when less invasive treatments fail.
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