Bronchial artery embolization (BAE) plays a crucial role in the treatment of hemoptysis, and its efficacy and safety have been proved. Although BAE is widely used in the treatment of hemoptysis, there is currently no standardized procedure for BAE, and there are significant differences between institutions and operators. To achieve standardization and normalization of the BAE in the treatment of hemoptysis, the Chinese College of Interventionalists (CCI) proposed this expert consensus, which is based on existing evidence and combined with clinical practice in China. This expert consensus is about patient selection, preoperative preparation, intraoperative procedures, postoperative management, efficacy evaluation and follow-up. After multiple rounds of discussion, this "expert consensus on the bronchial artery embolization in the treatment of hemoptysis" was proposed.
Humans ; Embolization, Therapeutic/methods* ; Hemoptysis/therapy* ; Bronchial Arteries ; Consensus

Hemoptysis is a serious medical emergency associated with high mortality rates. Notably, it poses significant therapeutic challenges owing to the complexities in rapidly identifying the bleeding site and underlying cause. In severe cases, it can lead to death by asphyxia, thus necessitating prompt intervention. Bronchoscopy-guided endobronchial balloon occlusion (EBBO) is a vital procedure for blocking the bleeding bronchus, allowing time for subsequent embolization of the responsible vessel and definitive treatment. While traditional techniques for EBBO are intricate and demanding, recent advancements in balloon technology, along with procedural refinements, have simplified the process, reduced operation times, and enhanced medical staff proficiency. Nevertheless, a lack of standardized protocols and technical guidelines has hindered the widespread adoption of this technique in China. Accordingly, the Internal Medicine of Chinese Medical Association convened a group of experts to develop the "Expert consensus on endobronchial balloon occlusion in the treatment of hemoptysis (2025 edition)" to standardize this procedure. This consensus, grounded in evidence-based medicine and clinical practice both domestically and internationally, covers seven essential elements: treatment strategies, equipment, indications and contraindications, preoperative preparation, technical procedures and specifications, integration with other therapeutic techniques, efficacy assessment, and follow-up. By offering comprehensive guidance, the consensus aims to standardize and promote the use of EBBO for hemoptysis management in China.
Humans ; Hemoptysis/therapy* ; Balloon Occlusion/methods* ; Bronchoscopy ; Consensus ; Evidence-Based Medicine

Humans ; Hemoptysis ; Myocardial Infarction/therapy* ; Percutaneous Coronary Intervention/adverse effects* ; Treatment Outcome ; ST Elevation Myocardial Infarction

Objective: To summarize the clinical characteristics of bronchial-pulmonary artery fistula and evaluate the effect of interventional closure of bronchial-pulmonary artery fistula. Methods: A retrospective case study was conducted. Fifteen children with hemoptysis who were diagnosed with bronchial-pulmonary artery fistula in Beijing Children's Hospital, Capital Medical University from January 2018 to March 2022 were selected. Their clinical symptoms and chest-enhanced CT findings were recorded. The children who failed to improve after anti-infection and hemostasis treatment were treated with transcatheter embolization through microparticles under digital subtraction angiography (DSA). The efficacy and post-operation recurrence were evaluated. Results: There were 15 children, including 9 males and 6 females, aged 9.8 (3.7, 12.1) years, weighing 35 (16, 55) kg. There was hemoptysis of varying degrees before surgery. Only 2 children had decreased hemoglobin. Chest enhanced CT showed that their bronchial arteries were thickened and tortuous, including 11 cases of single vessel disease and 4 cases of multivessel disease; 11 children had varying degrees of pneumonia and 4 children had atelectasis. Except for one case effectively treated with medical therapy, the remaining 14 cases were all treated with transcatheter interventional closure with embolic microparticles, among whom 12 had their fistula completely blocked with a single operation and the other 2 children underwent multiple operations because of too many fistulas. One child had extensive bronchial-pulmonary artery fistula which failed to be blocked completely even after multiple operations. Among the remaining 13 children, only 2 patients whose fistula was considered to be completely closed had recurrence presenting with hemoptysis at 3 months and 2 years after the operation, and no hemoptysis was found after the second closure. All children were discharged without chest pain, spinal cord paraplegia, or other serious complications. Fourteen children were followed up for 1.4 (0.9,2.9) years, among whom one still has intermittent mild hemoptysis due to incomplete closure and the rest had a satisfactory outcome. Conclusions: Hemoptysis is the first symptom of bronchial-pulmonary artery fistula. For children with failed medical treatment, transcatheter closure with an embolic pellet is effective, safe and feasible, with a low recurrence rate.
Child ; Female ; Male ; Humans ; Pulmonary Artery ; Retrospective Studies ; Chest Pain ; Hemoptysis/therapy* ; Hospitals, Pediatric

A 35-year-old man presented with progressive dyspnea and hemoptysis. His blood pressure was 230/140 mmHg and serum creatinine level was 20.13 mg/dL. Chest radiography and computed tomography revealed pulmonary hemorrhage. His renal function was low, thus emergent renal replacement therapy was required. Malignant hypertension and acute kidney injury were diagnosed, and antihypertensive therapy and hemodialysis started immediately. Renal biopsy was performed to examine the underlying disease. Typical pathological changes of malignant hypertension, fibrinoid necrosis of the afferent arterioles, and proliferative endoarteritis at the interlobular arteries were observed. His renal function improved gradually and pulmonary hemorrhage completely disappeared with administration of antihypertensive agents. Here, we report this rare case of malignant hypertension with pulmonary alveolar hemorrhage and speculate that the hemorrhage may be related to vascular injuries at the alveolar capillary level caused by malignant hypertension.
Acute Kidney Injury ; Adult ; Antihypertensive Agents ; Arteries ; Arterioles ; Biopsy ; Blood Pressure ; Capillaries ; Creatinine ; Dialysis* ; Dyspnea ; Hemoptysis ; Hemorrhage* ; Humans ; Hypertension, Malignant* ; Necrosis ; Pulmonary Alveoli ; Radiography ; Renal Dialysis ; Renal Replacement Therapy ; Thorax ; Vascular System Injuries

Extra pelvic endometriosis is considered to be rare. This paper reports a case of catamenial hemoptysis accompanied by subcutaneous endometriosis in 26-year-old woman. A computed tomography scan of the chest revealed a focal ground-glass opacity lesion in the posterior segment of the right upper lobe. Histopathology confirmed the diagnosis of endometriosis of right lung and concurrent subcutaneous endometriosis. She was treated with surgical resection of the endometriosis lesions on two different sites and perioperative gonadotropin-releasing hormone agonist therapy. The 6-month follow-up after combination treatment showed no recurrence. Though long-term follow-up result is needed, aggressive treatment using combination treatment (surgery and perioperative medication) should be considered for symptomatic extra pelvic endometriosis.
Adult ; Diagnosis ; Drug Therapy ; Endometriosis* ; Female ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Hemoptysis* ; Humans ; Lung ; Recurrence ; Thorax

Diffuse alveolar hemorrhage (DAH) is an uncommon complication in patients with systemic lupus erythematosus (SLE), and mortality remains high. In recent years, cases of DAH due to SLE treated with extracorporeal membrane oxygenation (ECMO) have rarely been reported. The authors present a case of a 43-year-old woman with SLE who had rapidly aggravating dyspnea and hemoptysis. She was diagnosed as having DAH with refractory respiratory failure and was successfully managed with veno-venous ECMO. We propose ECMO as a useful salvage therapy in patients with alveolar hemorrhage secondary to SLE who are failing conventional ventilatory support.
Adult ; Dyspnea ; Extracorporeal Membrane Oxygenation* ; Female ; Hemoptysis ; Hemorrhage* ; Humans ; Lupus Erythematosus, Systemic* ; Mortality ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency ; Salvage Therapy

OBJECTIVETo investigate the etiology and clinical manifestation of hemoptysis in children.

METHODA retrospective analysis was performed for 106 cases of hemoptysis who were admitted to The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University from January 2005 to December 2014.The clinical information including laboratory tests and image data were collected and analyzed.

RESULTA total of 106 patients (50 males and 56 females) were identified. The median age was 9.1 years (range 2 months to 18 years). Pneumonia (35, 31.1%) was the most common etiology of hemoptysis, which included bacterial pneumonia (27 cases), mycoplasmal pneumonia(4 cases), chlamydial pneumonia (3 cases), and influenza pneumonia(1 case). Other causes included bronchitis(15, 14.2%), pulmonary tuberculosis (11, 10.4%), bronchiectasis (11, 10.4%), diffuse alveolar hemorrhage (8, 7.5%), idiopathic pulmonary hemosiderosis(6, 5.7%), cardiovascular dysplasia(6, 5.7%), pulmonary contusion (4, 3.8%), foreign body in bronchus (2, 1.9%), allergic bronchopulmonary aspergillosis (2, 1.9%). Eighty-six patients manifested mild hemoptysis; moderate and massive hemoptysis were found in nine and eleven patients, respectively. Pneumonia accounted for 33.7% of mild hemoptysis and 45.5% of massive hemoptysis were due to bronchiectasis; 80.2% were treated with antibiotics and 41.5% were given hemostatic agents; 8.5% received lobectomy. Ninety-six patients (90.6%) were cured and parents gave up treatment in 4 cases (3.8%). Six patients (5.7%) suffered from recurrent hemoptysis.

CONCLUSIONHemoptysis mainly occurred in children who were older than 6 years, the most common cause of hemoptysis was respiratory tract infection. In most cases, the amount of hemoptysis was small and the overall prognosis was good.

Adolescent ; Bronchiectasis ; complications ; Bronchitis ; complications ; Child ; Child, Preschool ; Female ; Foreign Bodies ; complications ; Hemoptysis ; diagnosis ; etiology ; therapy ; Hemosiderosis ; complications ; Humans ; Infant ; Influenza, Human ; complications ; Lung Diseases ; complications ; Lung Injury ; complications ; Male ; Pneumonia, Bacterial ; complications ; Prognosis ; Retrospective Studies ; Tuberculosis, Pulmonary ; complications

Haemoptysis is commonly seen in the healthcare setting. It can lead to life-threatening complications and therefore requires careful evaluation of the severity and status of the patient. Common causes of haemoptysis can be broadly grouped into five main categories: infective, neoplastic, vascular, autoimmune and drug-related. Detailed history-taking and careful physical examination are necessary to provide a diagnosis and assess the patient's haemodynamic status. Physicians must have a clear understanding of the criteria for further investigations and the need for a specialist or inpatient referral for management.
Diagnosis, Differential ; Female ; Hemodynamics ; Hemoptysis ; diagnosis ; diagnostic imaging ; therapy ; Hemorrhage ; Humans ; Medical History Taking ; Middle Aged ; Primary Health Care ; Referral and Consultation ; Tomography, X-Ray Computed

Diffuse alveolar hemorrhage (DAH) is an uncommon complication in patients with systemic lupus erythematosus (SLE), and mortality remains high. In recent years, cases of DAH due to SLE treated with extracorporeal membrane oxygenation (ECMO) have rarely been reported. The authors present a case of a 43-year-old woman with SLE who had rapidly aggravating dyspnea and hemoptysis. She was diagnosed as having DAH with refractory respiratory failure and was successfully managed with veno-venous ECMO. We propose ECMO as a useful salvage therapy in patients with alveolar hemorrhage secondary to SLE who are failing conventional ventilatory support.
Adult ; Dyspnea ; Extracorporeal Membrane Oxygenation ; Female ; Hemoptysis ; Hemorrhage ; Humans ; Lupus Erythematosus, Systemic ; Mortality ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency ; Salvage Therapy