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Query: UMLS:C0019079 (hemoptysis)
6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 70-year-old woman with a known chronic dissecting aneurysm of the descending thoracic aorta presented with new-onset back pain and hemoptysis. The hemoptysis was thought to be the result of invasion of the bronchial tree by the aneurysm. During surgical repair, a lesion that appeared to be a pulmonary abscess was discovered to be adhering to the aortic tissue, and the patient underwent a localized pulmonary resection. The pathology report of the surgical specimens revealed squamous cell carcinoma of the lung with infiltration of the aortic wall. The patient died of lung cancer 6 months later. Hemoptysis was an unusual presentation in a case of lung cancer that had invaded a stable chronic aortic aneurysm.
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PMID:Hemoptysis as an unusual presenting symptom of invasion of a descending thoracic aortic aneurysmal dissection by lung cancer. 1207 73

A 56-year-old man, with Noonan's syndrome, underwent surgical correction of an aortic co-arctation almost two decades before his sudden and unexpected demise. The immediate cause of death was massive pulmonary haemorrhage, which was preceded by recurrent mild haemoptysis that was attributed to pneumonia, clinically. Autopsy revealed the presence of a saccular thoracic aortic aneurysm, arising from the apparently weakened anastomosis left by the previous operation. The aneurysm had eroded into the apical segment of the left lung, where it perforated with consequent severe, acute pulmonary haemorrhage. It was observed that the anastomotic line traversed the aneurysmal wall, with the resultant formation of a true aneurysm, rather than merely a pseudo-aneurysm. It is postulated that this finding of an iatrogenic true aneurysm represents a rare, delayed complication of aortic surgery.
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PMID:Fatal pulmonary haemorrhage from a perforated and possibly iatrogenic thoracic aortic aneurysm. 1208 95

An 80-year-old female was admitted with sudden onset of back pain and hemoptysis. The diagnosis was ruptured descending aortic aneurysm with the left lung hematoma. Emergency operation was performed. The graft replacement of the ruptured descending thoracic aneurysm and left lower lobectomy was done. She was extubated on the 1st postoperative day. The postoperative course was uneventful without pulmonary and graft complications. We thought that concomitant left lower lobectomy was useful in this patient.
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PMID:[Surgical treatment for ruptured descending thoracic aortic aneurysm with the left lung hematoma; report of a case]. 1213 92

Two patients, a 72-year-old man and a 34-year-old woman, presented with severe pain in the lower back and abdomen, respectively, accompanied by acute dyspnoea. One patient presented additionally with a palpable pulsatile abdominal mass and a continuous harsh bruit. He subsequently developed massive haemoptysis and went into deep shock. The second patient presented with peripheral cyanosis and a loud systolic heart murmur. She developed increasing respiratory distress and was maximally supported in the intensive care unit. Further investigation revealed acute left-to-right shunting based on rupture of an aortic aneurysm into the venous system in both patients; in the first this was into the V. cava inferior and in the second this was into the right atrium. In both patients, high-output heart failure was present. Acute right heart failure due to a fistula between the aorta and the venous system is a life-threatening and rapidly worsening haemodynamic disturbance. The diagnosis is not difficult but the condition is rare. In some cases, the patient's survival can be achieved by prompt diagnosis followed by operative closure of the fistula.
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PMID:[Acute right heart failure due to aortic aneurysm: 2 patients with an aortocaval shunt]. 1223 63

The differential diagnosis of hemoptysis includes a wide spectrum of infectious, autoimmune, and neoplastic diseases as well as chest trauma. The clinical presentation of a mycotic aortic aneurysm is often nonspecific, but mortality is high, especially after aneurysmal rupture. A high index of suspicion is warranted in any patient presenting with hemoptysis and a recent past history of subacute bacterial endocarditis, intravascular interventions, known aortic aneurysm, and/or immunocompromised state. A case report is presented of a patient with an ascending aortic mycotic aneurysm eroding into the adjacent lung, leading to chest pain, dyspnea, and hemoptysis. This case report provides an important lesson of the need to expand the differential
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PMID:Expanding the differential diagnosis of hemoptysis: mycotic aortic aneurysms. 1294 44

This report describes 3 aged patients undergoing emergent surgery who refused elective operation for a thoracic aortic aneurysm because of freedom from symptoms attributable to the aneurysm at the time of presentation. A 77-year-old woman with a thoracoabdominal aneurysm 57 mm in diameter at presentation had recurrent hemoptysis 12 months later. A 78-year-old man with a saccular type distal arch aneurysm 64 mm in diameter at presentation was transported with shock and hemothorax 27 months later. Another 82-year-old man with a saccular type distal arch aneurysm 60 mm in diameter at presentation was admitted with severe chest and back pain 36 months later. All of them underwent tube graft replacements of the aneurysm urgently and were discharged on foot. Aged patients with life-threatening events should not be denied surgical intervention because of excessive operative mortality and morbidity, even if they had previously refused elective surgery.
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PMID:Emergent surgery for 3 aged patients who refused elective operation for thoracic aortic aneurysm. 1452 61

A 63-year-old man had undergone graft replacement of the descending aorta due to dissection of aortic aneurysm nine years before and closure of an aortobronchopulmonary fistula two years before. He was admitted to our hospital because of massive hemoptysis. Angiography and chest computed tomography (CT) revealed a pseudoaneurysm on the proximal end caused by graft detachment. Intravascular ultrasound clearly revealed half round detachment on both ends of the graft. Replacement of the ascending, arch and distal aorta including the graft was performed, and the patient's postoperative course has been satisfactory. We have concluded that intravascular ultrasound is a useful method for detecting pseudoaneurysm after graft replacement which is not evident on cineangiography, CT or distal subtraction angiography.
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PMID:Intravascular ultrasound imaging for detection of pseudoaneurysm with aortobronchopulmonary fistula after graft replacement of descending aorta. 1514 12

A 66-year-old woman was transferred to our hospital for emergency treatment of a ruptured abdominal aortic aneurysm (AAA) and impending rupture of a descending thoracic aortic aneurysm (TAA) caused by a Stanford type-B dissection. She had severe coronary artery disease and a highly calcified aorta, and had been taking long-term steroids for rheumatoid arthritis. Endovascular repair of the TAA failed because the femoral artery was too small, so we performed simultaneous repair of the TAA and the AAA. A temporary axillofemoral bypass was constructed and the AAA was replaced with a bifurcated prosthetic graft. A thoracic stent graft was delivered successfully through a chimney graft of the abdominal graft. About 4 months later, the TAA extended proximally, causing hemoptysis, which was stopped by placing a new stent graft proximal to the previous one. This case report shows that a combination of open and endovascular repair is useful for treating a TAA with an AAA, especially in a small or frail patient.
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PMID:Simultaneous open and endoluminal repair of ruptured abdominal and thoracic aortic aneurysms: report of a case. 1552 34

Aortoesophageal fistula secondary to thoracic aneurysm is rare and is usually fatal without prompt surgical intervention. A 79-year-old man with significant comorbidities and previous cancer surgery was admitted on an emergency basis because of the suspicion of a ruptured thoracic aortic aneurysm. Computed tomographic scan followed by angiography demonstrated a ruptured thoracic aneurysm with aortoesophageal fistula. An endovascular stent graft repair was performed with successful exclusion of both aneurysm and fistula. On postoperative day 6, dyspnea and an isolated episode of hemoptysis occurred. Endoscopy revealed the presence of a bronchoesophageal fistula, which necessitated double exclusion of the esophagus and feeding jejunostomy. At 6 months, clinical, bronchoscopic, and computed tomographic scan follow-up showed complete sealing of the aneurysm and resolution of the bronchoesophageal fistula. At 9 months, the patient was still alive but refused to undergo substernal gastric bypass in an attempt to restore oral feeding. Endovascular repair seems promising as an emergent and palliative treatment of aortoesophageal fistula. To the best of our knowledge, this is the first case in which a bronchoesophageal fistula developed after successful endovascular repair of aortoesophageal fistula. The pathogenesis of this complications remains unclear.
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PMID:Bronchoesophageal fistula after endovascular repair of ruptured aneurysm of the descending thoracic aorta. 1587 38

A 58-year-old man was admitted for an aortoesophageal fistula (AEF) resulting from a thoracic aortic aneurysm. He underwent immediate in-situ prosthetic graft replacement, primary esophageal repair and wrapping of the aneurysm. Postoperative upper gastrointestinal endoscopy and computerized tomography (CT) findings were unremarkable. He was discharged on postoperative day (POD) 25. Three months after surgery, he was readmitted with complaints of worsening cough and hemoptysis. CT showed a thrombosed aneurysm adjacent to the left bronchus. Aortobronchial fistula due to mycotic pseudoaneurysm was suspected. The patient underwent immediate resection of the infected graft and prosthetic graft replacement positioned to avoid the infected area. The graft was wrapped with omentum. On POD 7, pleural empyema developed, and esophagography revealed a residual leak. Staged reconstruction of the esophagus was performed successfully. We conclude that even if the fistulous opening is small, simultaneous esophageal resection should be performed during the initial treatment of AEF.
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PMID:Aortobronchial fistula resulting from a mycotic pseudoaneurysm after treatment of an aortoesophageal fistula due to a thoracic aortic aneurysm. 1636 23


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