Aortobronchial fistula may cause a massive fatal hemoptysis. Recently prosthetic aortic graft insertion or endovascular stent graft is a cause of aortobronchial fistula. We report a rare case of hemoptysis from a fistula between an aortic arch aneurysm and the left main bronchus in a patient who had undergone an endovascular stent graft in pseudoaneurysm of descending thoracic aorta one year before.
Aneurysm ; Aneurysm, False ; Aorta, Thoracic ; Blood Vessel Prosthesis* ; Bronchi ; Fistula* ; Hemoptysis* ; Humans ; Stents* ; Transplants

Platelets play an important role in the development of acute coronary syndrome. Platelet-inhibiting drugs, such as glycoprotein IIb/IIIa inhibitors, can be beneficial when they are administered at the time of primary percutaneous coronary intervention for acute coronary syndrome. Although an increased risk for bleeding complications is well recognized, the risk associated with diffuse alveolar hemorrhage is much less reported. We report a case of diffuse alveolar hemorrhage after using abciximab.
Acute Coronary Syndrome ; Antibodies, Monoclonal ; Blood Platelets ; Glycoproteins ; Hemoptysis ; Hemorrhage ; Immunoglobulin Fab Fragments ; Percutaneous Coronary Intervention

A girl was diagnosed with intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) due to pyrexia and hemoptysis for eight days. The girl was a school-age child with major clinical manifestations of pyrexia, skin rash, enlargement of bilateral cervical lymph nodes, conjunctival hyperaemia, red and cracked lips and strawberry-like tongue, followed by swelling of both hands and feet. Laboratory examination showed significant increases in white blood cell count, platelet count, C-reactive protein, erythrocyte sedimentation rate and liver enzymes, a significant reduction in albumin, and the presence of aseptic pyuria. After the first course of IVIG treatment, the girl still had recurrent pyrexia, with hemoptysis on day 2 after admission, and lung CT showed uneven luminance and patchy shadow. The symptoms were quickly alleviated after the second course of IVIG treatment combined with methylprednisolone and aspirin treatment. KD is a febrile disease characterized by multiple systemic vasculitis in childhood and can involve various organ systems such as the heart, lungs, kidneys and the nervous system. Therefore, it is necessary to carefully monitor and recognize the rare symptoms of KD, and early recognition of pulmonary complications of KD can avoid delay in diagnosis, prevent the development of more serious complications, and help with early treatment and disease recovery.
Blood Sedimentation ; Child ; Female ; Fever ; Hemoptysis ; Humans ; Immunoglobulins, Intravenous ; Mucocutaneous Lymph Node Syndrome

PURPOSE: Vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2) are major mediators of angiogenesis and are induced by tissue inflammation and hypoxia. The purpose of this study was to investigate whether serum VEGF and Ang-2 are associated with the presence of hemoptysis and the extent of systemic inflammation in patients with inflammatory lung diseases. MATERIALS AND METHODS: We prospectively enrolled 52 patients with inflammatory lung disease between June 2008 and October 2009. RESULTS: The median values of VEGF and Ang-2 were 436 pg/mL and 2383 pg/mL, respectively. There was a significant positive correlation between serum Ang-2 and VEGF levels. VEGF levels were not significantly different according to the presence of hemoptysis. C-reactive protein (CRP) and Ang-2 level were significantly higher in patients without hemoptysis (n=26) than in those with hemoptysis (n=26; p<0.001 and p<0.001, respectively). CRP and arterial oxygen tension (PaO2) were significantly correlated with both serum VEGF (p=0.032 and p=0.016, respectively) and Ang-2 levels (p<0.001 and p=0.041, respectively), after adjusting for other factors. Age and the absence of hemoptysis were factors correlated with serum Ang-2 levels CONCLUSION: Our study suggests that serum VEGF and Ang-2 levels are associated with PaO2 and the severity of inflammation rather than the presence of hemoptysis in patients with inflammatory lung diseases. Thus, hemoptysis may not be mediated by increased serum levels of VEGF and Ang-2 in patients with inflammatory lung diseases, and further studies are required to determine the mechanisms of hemoptysis.
Aged ; Angiopoietin-2/*blood ; Female ; Hemoptysis/*blood ; Humans ; Inflammation/*blood ; Lung Diseases/*blood ; Male ; Middle Aged ; Prospective Studies ; Vascular Endothelial Growth Factor A/*blood

Paraganglioma is a tumor from the extra adrenal paraganglion system and is rarely observed in the mediastinum. The authors experienced a case of nonfunctioning paraganglioma of the posterior mediastinum. The patient was 34-years-old male in whom abnormal mass lesion was nites in chest radiograph with hemoptysis. His blood pressure and serologic examination were within normal range upon admission to our hospital. Chest CT revealed a tumor in the left lower lobe. Diagnostic thoracoscopy was performed and diagnosed a posterior mediastinal mass. Surgical resection was them performed. Posterior mediastinal mass was removed successfully and histological examination of the surgical specimen diagnosed paraganglioma. He received radiotherapy after surgery and was followed up. Related literature are reviewed.
Blood Pressure ; Hemoptysis ; Humans ; Male ; Mediastinum* ; Paraganglioma* ; Radiography, Thoracic ; Radiotherapy ; Reference Values ; Thoracoscopy ; Tomography, X-Ray Computed

Thoracic aortic aneurysms are potentially life-threatening. They are caused by atherosclerosis, most commonly of the descending aorta. Clinical manifestations are due to the compression or erosion of adjacent structures, dissection, or rupture. Thoracic aortic aneurysms account for 50 to 60 percent of aortobronchopulmonary fistulas. Symptoms of aortobronchopulmonary fistulas include constant chest or back pain, cough, and dyspnea, as well as hemoptysis, which occurs in over 95 percent of cases. Recently, aortobronchial fistula, caused by thoracic aortic aneurysms, has been successfully treated with an endovascular stent graft. We report a patient with aortobronchial fistula presenting with hemoptysis, who was successfully treated with an endovascular stent graft.
Aorta, Thoracic ; Aortic Aneurysm, Thoracic* ; Atherosclerosis ; Back Pain ; Blood Vessel Prosthesis* ; Cough ; Dyspnea ; Fistula* ; Hematemesis ; Hemoptysis ; Humans ; Rupture ; Stents* ; Thorax

Thoracic aortic aneurysms are potentially life-threatening. They are caused by atherosclerosis, most commonly of the descending aorta. Clinical manifestations are due to the compression or erosion of adjacent structures, dissection, or rupture. Thoracic aortic aneurysms account for 50 to 60 percent of aortobronchopulmonary fistulas. Symptoms of aortobronchopulmonary fistulas include constant chest or back pain, cough, and dyspnea, as well as hemoptysis, which occurs in over 95 percent of cases. Recently, aortobronchial fistula, caused by thoracic aortic aneurysms, has been successfully treated with an endovascular stent graft. We report a patient with aortobronchial fistula presenting with hemoptysis, who was successfully treated with an endovascular stent graft.
Aorta, Thoracic ; Aortic Aneurysm, Thoracic* ; Atherosclerosis ; Back Pain ; Blood Vessel Prosthesis* ; Cough ; Dyspnea ; Fistula* ; Hematemesis ; Hemoptysis ; Humans ; Rupture ; Stents* ; Thorax

The Rendu-Osler-Weber syndrome (hereditary hemorrhagic telangiectasia) is an autosomal dominant disorder of blood vessels associated with mucocutaneous telangiectasis and arterivenous malformations in several organs. A pulmonary arteriovenous fistulae can cause hypoxemia, hemoptysis, polycythemia and clubbing. However the condition is often not recognized until the 3rd decade of life. The authors report a case of a 28-year-old male patient who had been suffering from telangiectasis of the upper lip and upper portion of the chin and unexpedly became undersaturated of hemoglobin through general anesthesia during an operation of the upper lip lesion.
Adult ; Anesthesia, General ; Anoxia ; Arteriovenous Fistula ; Blood Vessels ; Chin ; Hemoptysis ; Humans ; Lip ; Male ; Polycythemia ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis

After the percutaneous transarterial technique was introduced by Seldinger in 1953, the percutaneous transcatheter embolization technique was developed. Autologous clot, first used by Doppman in 1968 to occlude a spinal arteriovenous malformation, was quickly adopted for management of gastrointestinal hemorrhage, genitourinary hemorrhage, traumatic hemorrhage, and hemoptysis. The notable improvement of the angiographic techniques rendered the interventional treatment the mainstay in the management of bleeding. Interventional treatment can be a life-saving procedure for massive bleeding or an important adjunct in reducing blood loss during operation and occasionally radical treatment of bleeding diseases. The goal of embolotherapy is to reduce the pulse pressure in the bleeding artery while maintaining an enough collateral flow to preserve the tissue viability. A variety of embolic materials have been proved safe and effective. Gelfoam pledget, polyvinyl alcohol, and coil are most commonly used. Gelfoam powder, extremely small polyvinyl alcohol, and absolute alcohol should be used carefully because of the risk of mucosal ischemia and necrosis.
Arteries ; Arteriovenous Malformations ; Blood Pressure ; Embolization, Therapeutic ; Ethanol ; Gastrointestinal Hemorrhage ; Gelatin Sponge, Absorbable ; Hemoptysis ; Hemorrhage* ; Ischemia ; Necrosis ; Polyvinyl Alcohol ; Tissue Survival

Lymphangioleiomyomatosis (LAM) is a rare disease in women in childbearing age leading to progressive respiratory failure. LAM is characterized by an abnormal harmartomatous proliferation of smooth muscle cells surrounding the blood vessels, lymphatics and airways in the lung. This proliferation leads to airway obstruction, cystic alveolar change and lymphatic obstruction. Patients present with dyspnea, pneumothorax, cough, chest pain, hemoptysis, and chylous effusion. Although lung transplantation is the only therapeutic modality in end-stage LAM with respiratory failure, there has not been any report of successful treatment in Korea. We report one case of successful left single lung transplantation in a 40 year old woman suffering from end-stage LAM.
Adult ; Airway Obstruction ; Blood Vessels ; Chest Pain ; Cough ; Dyspnea ; Female ; Hemoptysis ; Humans ; Korea ; Lung Transplantation* ; Lung* ; Lymphangioleiomyomatosis* ; Myocytes, Smooth Muscle ; Pneumothorax ; Rare Diseases ; Respiratory Insufficiency