초록접수 현황
| 14F-125 | 포스터 발표 |
Bronchial Artery Aneurysm Presenting as Hematemesis
Ji Sung Kim, So Young Lee, Kuk Hui Son, Kun-Woo Kim, Chang Hu Choi, Kook Yang Park, Jae-Ik Lee, Chul Hyun Park
Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University, Incheon, Republic of Korea
Background : Hematemesis is a very rare manifestation of the ruptured bronchial artery aneurysm(BAA) in the mediastinum. A ruptured BAA with hematemesis is difficult to diagnose, because it can be confused with other diseases such as Boerhaave's syndrome, variceal disease, or perforated ulcer. We would describe a case of the bronchial artery aneurysm resulting in hematemesis and mediastinal hemorrhage.
Methods : A 55-year-old male, who was treated for spontaneous pneumothorax 7 years ago, was presented to the emergency department complaining of chest pain, neck swelling and dysphagia. During the physical examination, he vomited bright red blood three times. On nasogastric tube aspiration, fresh blood came out.A computed tomography (CT) showed extensive soft tissue lesions in mediastinum and neck, which were suspected of hematoma. A gastroscopy showed no definite focus of bleeding. Since the patient was hemodynamically stable, a conservative management was adopted in intensive care unit.
Results : The follow-up CT on the 3rd postadmission day showed the focal aneurysm in the right bronchointercostal trunk. One-cm sized aneurysm in the right bronchial artery was found on the subsequent selective bronchial arteriography. The right bronchial artery was embolized with coils and glues, and mediastinal hematoma nearly disappeared on repeated CT. He was discharged without complications.
Conclusion : In patients presenting with hematemesis and mediastinal hemorrhage at same time, one should keep in mind the possibility of the ruptured bronchial artery aneurysm.
Methods : A 55-year-old male, who was treated for spontaneous pneumothorax 7 years ago, was presented to the emergency department complaining of chest pain, neck swelling and dysphagia. During the physical examination, he vomited bright red blood three times. On nasogastric tube aspiration, fresh blood came out.A computed tomography (CT) showed extensive soft tissue lesions in mediastinum and neck, which were suspected of hematoma. A gastroscopy showed no definite focus of bleeding. Since the patient was hemodynamically stable, a conservative management was adopted in intensive care unit.
Results : The follow-up CT on the 3rd postadmission day showed the focal aneurysm in the right bronchointercostal trunk. One-cm sized aneurysm in the right bronchial artery was found on the subsequent selective bronchial arteriography. The right bronchial artery was embolized with coils and glues, and mediastinal hematoma nearly disappeared on repeated CT. He was discharged without complications.
Conclusion : In patients presenting with hematemesis and mediastinal hemorrhage at same time, one should keep in mind the possibility of the ruptured bronchial artery aneurysm.
책임저자: 박철현
가천대학교 의과대학 길병원 흉부외과학교실
연락처 : 김지성, Tel: 032-460-3669 , E-mail : mirkim11@gmail.com
