Case report
Hemoptysis Secondary to Pulmonary Artery Pseudoaneurysm After Necrotizing Pneumonia

https://doi.org/10.1016/j.athoracsur.2007.05.024Get rights and content

This case documents the occurrence of hemoptysis secondary to pulmonary artery pseudoaneurysm in a 19-year-old man who was admitted for hypertriglyceridemic pancreatitis. The pseudoaneurysm derived from a necrotizing pneumonia within the same pulmonary segment. After an extensive workup, the pseudoaneurysm was diagnosed by pulmonary angiography and treated with coil embolization.

Section snippets

Comment

Hemoptysis can be a life-threatening event. Bleeding usually derives from pulmonary or bronchial arteries. Causative factors include tracheobronchial disease, foreign bodies, neoplasms, tracheo-innominate fistula, arteriovenous malformation, pulmonary embolism, or coagulopathies. The workup consists of bronchoscopy, computed tomographic scan, and possibly magnetic resonance imaging of the chest [1, 2, 3]. Kierse and colleagues [4] described the benefits of multi-slice chest computed tomography

Cited by (12)

  • Bronchial artery pseudoaneurysm with symptomatic mediastinal hematoma

    2014, Clinical Imaging
    Citation Excerpt :

    The most common initial symptom is often hemoptysis. The bronchi and arteries share a common connective tissue sheath; if the aneurysm ruptures the blood can directly enter the bronchus producing hemoptysis [7]. Ruptures that are more media-dorsal can cause compression of the esophagus producing dysphagia or rupture directly into the esophagus causing hematemesis mimicking symptoms of esophageal cancer and Mallory-Weiss tears [8].

  • Pulmonary artery pseudoaneurysm after MRSA septicemia in a pediatric patient

    2013, Journal of Pediatric Surgery
    Citation Excerpt :

    It is theorized that excessive inflammation from pyogenic agents results in breakdown of the pulmonary artery wall, leading to the formation of a pseudoaneurysmal cyst. Subsequent rupture and hemoptysis may occur when the active inflammatory process potentiates erosion of the feeding vessel into the bronchi [10]. To our knowledge, this is the only reported case of a PAP secondary to a known infectious cause in a pediatric patient.

  • Pulmonary artery pseudoaneurysm arising secondary to cavitary pneumonia

    2012, Radiology Case Reports
    Citation Excerpt :

    Infection and inflammation have been associated with pseudoaneuryms in the systemic circulation, but are seen less commonly in the pulmonary circulation. Pyogenic infection is a potential cause of pulmonary artery pseudoaneurysm formation secondary to the active inflammatory process that erodes the feeding vessel into the bronchi (4, 5). Causative microorganisms include S. Aureus (22%), Salmonella species (17%), Streptococcus species (11%), and Enterococcus species (11%) (6).

  • Pulmonary Artery Pseudoaneurysm After a Vascular Access Port Catheter Implantation

    2009, Annals of Thoracic Surgery
    Citation Excerpt :

    We believe that this is the first reported case in which a port catheter was involved in such an event. Presentation changes according to the localization and severity of pulmonary artery pseudoaneurysm includes fever, chest pain, dyspnea, and hemoptysis, which is the most frequent presenting symptom [6]. The diagnosis requires computed tomography with intravenous contrast or pulmonary artery angiogram, or both, to exclude an infection and metastasis.

  • Pulmonary artery pseudoaneurysm in a child with ß-thalassemia major

    2020, Journal of Pediatric Hematology/Oncology
View all citing articles on Scopus
View full text