[Communication between intercostal artery and pulmonary vein--report of a case]

A 55-year-old man was admitted to our hospital complaining of recurrent hemoptysis and his chest X-ray abnormality. Bronchoscopic and cytologic examination presented us no endoscopic and cytologic abnormality. Intercostal angiography demonstrated communications between intercostal arteries (4th and 5th) and right upper pulmonary vein via the abnormal shadow. Mild verval disturbance after angiographic examination forced us to abandon interventional therapy. And we carried out operation. In the operation, we found massive fibrous adhesion between the parietal pleula and the visceral pleura. And we also found several small vessels pouring from chest wall to upper lobe. We cut all these vessels using electrocautery and ligated 4th and 5th intercostal arteries at the proximal point of the communication. The patient recovered uneventfully. But after five months from operation, he had hemoptysis again. Angiographic examination revealed re-anastomosis between intercostal arteries and upper pulmonary vein. Therefore we carried out right upper and middle lobectomy. After three months from re-operation, he lived well with no hemoptysis.