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Massive Pulmonary Hemorrhage from Bronchial Varix
Bronchial varix is a rare pulmonary disorder which may lead to life-threatening hemorrhage. Diagnosis is difficult because of the subtle abnormalities on radiographic and bronchoscopic examination. We present a case of massive hemoptysis from a bleeding bronchial varix. In the absence of immediate c...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160734/ https://www.ncbi.nlm.nih.gov/pubmed/32313711 http://dx.doi.org/10.1155/2020/9175785 |
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author | Agustin, Michael Shay, Scott Gonzalez, Jose Liu, Pei Lentz, Nancy Shapiro, Anna Dumrongmongcolgul, Nat Torres, Michael Jungtrakoolchai, Vasin |
author_facet | Agustin, Michael Shay, Scott Gonzalez, Jose Liu, Pei Lentz, Nancy Shapiro, Anna Dumrongmongcolgul, Nat Torres, Michael Jungtrakoolchai, Vasin |
author_sort | Agustin, Michael |
collection | PubMed |
description | Bronchial varix is a rare pulmonary disorder which may lead to life-threatening hemorrhage. Diagnosis is difficult because of the subtle abnormalities on radiographic and bronchoscopic examination. We present a case of massive hemoptysis from a bleeding bronchial varix. In the absence of immediate complex endobronchial therapy in the island of Guam, this case was initially managed with nebulized and intravenous tranexamic acid. This was followed by endobronchial blockade of the bleeding airway with endobronchial epinephrine instillation. Selective bronchial artery embolization alleviated the acute-phase bleeding. Prone positioning was initiated due to severe hypoxia after blood clots compromised the patency of bilateral bronchial airways. Prone ventilation was employed for 17 hours for 2 consecutive days with intermittent bronchoscopic forceps extraction of airway blood clots while in the prone position. These maneuvers resulted to improved lung ventilation and oxygenation. The patient underwent bronchial sleeve resection surgery for definitive management. |
format | Online Article Text |
id | pubmed-7160734 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-71607342020-04-20 Massive Pulmonary Hemorrhage from Bronchial Varix Agustin, Michael Shay, Scott Gonzalez, Jose Liu, Pei Lentz, Nancy Shapiro, Anna Dumrongmongcolgul, Nat Torres, Michael Jungtrakoolchai, Vasin Case Rep Pulmonol Case Report Bronchial varix is a rare pulmonary disorder which may lead to life-threatening hemorrhage. Diagnosis is difficult because of the subtle abnormalities on radiographic and bronchoscopic examination. We present a case of massive hemoptysis from a bleeding bronchial varix. In the absence of immediate complex endobronchial therapy in the island of Guam, this case was initially managed with nebulized and intravenous tranexamic acid. This was followed by endobronchial blockade of the bleeding airway with endobronchial epinephrine instillation. Selective bronchial artery embolization alleviated the acute-phase bleeding. Prone positioning was initiated due to severe hypoxia after blood clots compromised the patency of bilateral bronchial airways. Prone ventilation was employed for 17 hours for 2 consecutive days with intermittent bronchoscopic forceps extraction of airway blood clots while in the prone position. These maneuvers resulted to improved lung ventilation and oxygenation. The patient underwent bronchial sleeve resection surgery for definitive management. Hindawi 2020-04-04 /pmc/articles/PMC7160734/ /pubmed/32313711 http://dx.doi.org/10.1155/2020/9175785 Text en Copyright © 2020 Michael Agustin et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Agustin, Michael Shay, Scott Gonzalez, Jose Liu, Pei Lentz, Nancy Shapiro, Anna Dumrongmongcolgul, Nat Torres, Michael Jungtrakoolchai, Vasin Massive Pulmonary Hemorrhage from Bronchial Varix |
title | Massive Pulmonary Hemorrhage from Bronchial Varix |
title_full | Massive Pulmonary Hemorrhage from Bronchial Varix |
title_fullStr | Massive Pulmonary Hemorrhage from Bronchial Varix |
title_full_unstemmed | Massive Pulmonary Hemorrhage from Bronchial Varix |
title_short | Massive Pulmonary Hemorrhage from Bronchial Varix |
title_sort | massive pulmonary hemorrhage from bronchial varix |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160734/ https://www.ncbi.nlm.nih.gov/pubmed/32313711 http://dx.doi.org/10.1155/2020/9175785 |
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