Spontaneous massive hemothorax due to inferior phrenic artery pseudoaneurysm: endovascular treatment approach
Resham Singh1, Annoushka Daniel1, Naveen Kumar1
1Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
Abstract:
Inferior phrenic artery (IPA) pseudoaneurysms are highly uncommon and result from trauma, pancreatitis, or iatrogenic injury. However, rupture can lead to catastrophic hemothorax. The vessel's deep location and non-specific symptoms make early identification a difficult task. We report a case of a 22-year-old woman who was undergoing antitubercular therapy and presented with the onset of acute dyspnea after a five-month history of wheezing and hemoptysis. Computed tomography angiography revealed a pseudoaneurysm originating from the left IPA and a massive left hemothorax. This pseudoaneurysm sac and the descending branch of the IPA were successfully embolized with a glue: lipiodol mixture, followed by hemothorax evacuation. The patient is asymptomatic at 2-month follow-up. Endovascular embolization minimizes morbidity and enables rapid recovery when anatomy is favorable. This report emphasizes the importance of cross-sectional imaging in the early diagnosis and treatment planning of atypical hemothorax presentations.
Related Concept Videos
Spontaneity
Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
Spontaneous and Induced Mutations


