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An unusual case of hemoptysis: Pulmonary artery pseudoaneurysm secondary to a lung abscess

Hiroyuki Tanaka1, Junji Uraki2, Motoaki Tanigawa3

  • 1Department of Infectious Diseases, Japanese Red Cross Ise Hospital, 471-2, Funae, Ise, Mie, 516-8512, Japan.

Respiratory Medicine Case Reports
|September 20, 2021
PubMed

Insights

Massive hemoptysis can stem from pulmonary artery pseudoaneurysms (PAPs). Transcatheter arterial embolization (TAE) effectively treated a PAP in a patient with a lung abscess, resolving severe bleeding.

Area of Science:

  • Cardiovascular Medicine
  • Pulmonology
  • Interventional Radiology

Background:

  • Massive hemoptysis is a life-threatening condition often linked to pulmonary artery pathologies.
  • Pulmonary artery pseudoaneurysms (PAPs) are rare but critical causes of severe bleeding.
  • Lung abscesses can predispose patients to vascular complications.

Observation:

  • A 93-year-old male with pneumonia and a subsequent lung abscess developed sudden massive hemoptysis.
  • Multi-detector computed tomography angiography (MDCTA) identified a pulmonary artery pseudoaneurysm within the lung abscess cavity.
  • The patient's hemoptysis ceased following treatment.

Findings:

  • Transcatheter arterial embolization (TAE) successfully occluded the pulmonary artery pseudoaneurysm and its feeding arteries.
  • MDCTA proved effective in diagnosing the PAP within the complex context of a lung abscess.
  • The patient experienced complete resolution of hemoptysis without recurrence post-embolization.

Implications:

  • Pulmonary artery pseudoaneurysms should be considered in the differential diagnosis of delayed massive hemoptysis in patients with lung abscesses.
  • MDCTA is a valuable tool for the diagnosis of PAPs in this clinical setting.
  • TAE offers a minimally invasive and effective treatment option for managing PAP-related massive hemoptysis.
Keywords:
HemoptysisLung abscessMulti-detector computed tomography angiographyPulmonary artery pseudoaneurysmTranscatheter arterial embolization

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