Open AccessTwo cases of cryptogenic life‐threatening hemoptysis – identification and management of bleeding point
Author(s) -
Okuda Kazunori,
Tanaka Jun,
Okamoto Jun,
Kishi Fumihisa,
Nakagawa Junichiro,
Hino Hiroshi,
Chujoh Satoru,
Shimadzu Kazuhisa,
Kishimoto Masafumi,
Kato Noboru,
Shiono Shigeru
Publication year - 2017
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.227
Subject(s) - medicine , bronchial artery , bronchoscopy , asphyxia , embolization , angiography , surgery , hypoxemia , bronchus , anesthesia , sedation , lung , radiology , respiratory disease
Cases Case 1: A 63‐year‐old woman was referred for coughing blood. Although cardiorespiratory dynamics were stabilized by artificial respiration under sedation, severely poor ventilation developed from asphyxia associated with massive respiratory tract hemorrhage. One‐lung ventilation was temporarily secured by endotracheal tube insertion into the left main bronchus just prior to cardiopulmonary arrest. Case 2: A 72‐year‐old man was referred for massive hemoptysis after coughing, then intubated and placed on a respirator. During angiography, blood clots collected with bronchoscopy confirmed extravascular leakage into the right main bronchus. Outcomes Both showed no hemoptysis recurrence after bronchial artery embolization and were discharged. Case 1 required intensive treatment for 6 days, including artificial respiratory management. Conclusion Emergency one‐lung ventilation was required for asphyxia in Case 1, and we had difficulties with bleeding point identification and hemostatic therapy. From that experience, we noted hemoptysis during angiography using bronchoscopy in Case 2, enabling prompt bronchial artery embolization.