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Pulmonary artery pseudoaneurysm after blunt thoracic trauma
Nair Andrade1, Ana Rita Nogueira2, Marisa Miranda2
1Intensive Care Unit, ULS Coimbra, Coimbra, Coimbra District, Portugal nairandrade5@gmail.com.
BMJ Case Reports
|March 31, 2026
Summary
Pulmonary artery pseudoaneurysms (PAPAs) are rare, life-threatening injuries from blunt chest trauma. This case highlights successful endovascular treatment of a PAPA causing severe bleeding and cardiac arrest weeks after injury.
Area of Science:
- Cardiology
- Thoracic Surgery
- Trauma Surgery
Background:
- Pulmonary artery pseudoaneurysms (PAPAs) are uncommon but critical complications following blunt thoracic trauma.
- These aneurysms can manifest as incidental findings or present with severe, life-threatening hemorrhage, such as massive hemoptysis.
Purpose of the Study:
- To report a case of a delayed pulmonary artery pseudoaneurysm (PAPA) secondary to severe blunt thoracic trauma.
- To illustrate the successful endovascular management of a symptomatic PAPA.
Main Methods:
- A case presentation of a male patient in his 30s who sustained severe blunt thoracic trauma from a tractor accident.
- Diagnosis of PAPA confirmed weeks after initial injury due to hemoptysis, desaturation, and cardiac arrest.
- Successful treatment using an 8 mm Amplatzer Vascular Plug via an endovascular approach.
Main Results:
- The patient developed severe hemoptysis, desaturation, and cardiac arrest weeks post-trauma, indicative of a ruptured PAPA.
- The endovascular intervention with an Amplatzer Vascular Plug effectively occluded the pseudoaneurysm.
- The patient's condition stabilized following the successful treatment.
Conclusions:
- Delayed presentation of PAPA after blunt thoracic trauma is possible and can be fatal.
- Endovascular treatment offers a viable and successful therapeutic option for managing PAPAs.
- Prompt recognition and intervention are crucial for improving outcomes in patients with traumatic PAPAs.
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