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

Ruptured aortic aneurysms present with various signs and symptoms depending on the site of rupture and bleeding, often causing sudden death; however, rupture into the lung with hemoptysis and blood aspiration is very rare. We report a case of unexpected sudden death due to blood aspiration from rupture of a thoracic aortic aneurysm into the lung. An 83 year old man, who had a past history of surgery for an abdominal aortic aneurysm about 17 years previously, was found dead on his bed with massive hemoptysis. Medico-legal autopsy revealed rupture of a thoracic aortic aneurysm into the left lung, causing massive blood aspiration. Tight, diffuse pleural adhesion and the vulnerable wall of an aortic aneurysm due to advanced atherosclerosis with active inflammation appeared to have predominantly contributed to the penetration of the ruptured aneurysm into the lung. This case suggests that long-term clinical follow-up and management are needed for a patient with aortic aneurysm, and that a ruptured aortic aneurysm should be taken into consideration to identify the source of bleeding for hemoptysis.
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PMID:An autopsy case of unexpected sudden death due to rupture of a thoracic aortic aneurysm into the left lung. 2137 96

Aortic rupture has a high mortality rate and can be considered a medical emergency. The standard treatment for aortic rupture is surgical repair. An aortic stent graft for a ruptured descending aorta is considered an effective alternative treatment. However, an aortic stent graft is difficult when the aortic aneurysm is in the aortic arch due to supra-aortic vessels. We report on a patient with a ruptured aortic arch aneurysm treated with a hybrid procedure, which involved a carotid to carotid bypass operation and an aortic stent graft. A 71-year-old male patient visited our cardiovascular center suffering from hemoptysis. The chest CT and aortography showed a 9 cm sized aortic arch aneurysm 0.5 cm distal to the left subclavian artery and a hemothorax in the left lung. The patient refused to undergo a full open operation. We performed a carotid to carotid bypass in advance, and two pieces of aortic stent grafts were placed across the left carotid artery and left subclavian artery. The follow up CT showed the aortic stent grafts, no endoleaks and no thrombus in the aortic arch aneurysm. The patient was discharged from the hospital without complication.
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PMID:Successful treatment of a ruptured aortic arch aneurysm using a hybrid procedure. 2194 32

An 84-year-old-man was admitted to the Department of Neurosurgery for a sudden episode of fainting. Brain computed tomography and magnetic resonance imaging demonstrated no fresh lesions. Anorexia, fever and elevation of C-reactive protein and creatine phosphokinase were observed, and the patient was transferred to the Department of Internal Medicine for further examination and treatment. High-dose steroids and antibiotics were administered, and his fever subsided. However, massive hemoptysis suddenly developed and the patient died. A thoracic aortic aneurysm that had coalesced and ruptured a left lung bronchus was detected at autopsy. Pathological examination revealed an inflammatory aortic aneurysm.
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PMID:Sudden death with massive hemoptysis from rupture of a thoracic inflammatory aortic aneurysm: an autopsy case report. 2250 59

We report a case of 74-year-old man presenting with a rupture of a thoracic aortic false aneurysm after undergoing conventional total arch replacement for aortic arch aneurysm (62 mm) and endovascular stent placement for descending aortic aneurysm (70 mm). His chief complaints at the present admission were fever and sensation of dyspnea and we put him on a course of antibiotics for stent graft infection. However he died of massive hemoptysis. From a standpoint of autopsy findings, a thoracic aortic false aneurysm formed at the just proximal landing zone owing to type Ia endoleak, and simultaneously stent graft infection lead to make fistula formation between the false aneurysm and the lung. We examined ourselves that stent graft infection and aortopulmonary fistula caused by an infected thoracic aortic false aneurysm rupturing into the lung should be promptly treated such as complete removal of the stent and another revascularization in a reasonable period of time except if there are complications such as comorbid1ities or withholding of consent. We experienced and reported one rare case associated with a rupture of thoracic aortic false aneurysm caused by stent graft infection and the fistulization between the lung and the stent graft.
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PMID:Aortopulmonary fistula caused by an infected thoracic aortic false aneurysm rupturing after endovascular stent placement. 2322 49

We report a 47-year-old man with diabetics presenting with massive haemoptysis. Physical examination showed moderate pallor, but was otherwise normal. Evaluation showed normal bleeding and clotting parameters. Aerobic cultures of sputum samples and acid-fast staining were negative. CT showed fusiform aneurysmal dilation of the descending thoracic aorta compressing the left main bronchus with secondary collapse of the left lower and lingular lobes. Massive haemoptysis was attributed to probable erosion of the aneurysm into the left main bronchus. Retrospective questioning failed to elicit pathognomic symptoms of aortic aneurysm including chest pain. While in the hospital, the patient had another bout of massive haemoptysis, requiring endotracheal intubation for airway protection. Chest x-ray revealed homogeneous opacification of the left hemithorax. The patient was treated with antitussives and blood transfusions and referred to a higher centre for endovascular stent grafting of the aneurysm and simultaneous surgical repair of the left main bronchus. Aortic aneurysm is a rare but deadly cause for haemoptysis, as rapid exsanguination can lead to cardiovascular collapse and death.
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PMID:An unusual and deadly cause for massive haemoptysis. 2341 92

A 70-year-old woman with a medical history of descending aorta replacement for chronic type B aortic dissection 12 years prior was admitted to our hospital with sudden back pain and hemoptysis. The patient was diagnosed with ruptured residual dissected thoracic aortic aneurysm and underwent emergent endovascular treatment. Two TAG thoracic endoprosthesis of different sizes were used to accommodate the discrepancy in size of the true lumen, resulting in a successful closure of the entry tear and hemostasis, without any damage to the intima. Computed tomography performed 3 months after surgery revealed successful remodeling of the remaining aorta. Thoracic endovascular aortic replacement may be considered as an option in the treatment of chronic dissected aortic aneurysm, achieving not only entry closure but possibly remodeling, as well.
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PMID:Successful remodeling and endovascular repair of a ruptured type B chronic aortic dissection 12 years after primary surgery. 2351 26

Thoracic type B2 fractures are high-energy injuries. It is crucial to maintain a high index of suspicion for concomitant visceral injuries. A 33-year-old man presented after a motor vehicle accident with a T4 type B2.3 fracture with an associated sternum fracture. He was treated with a T4 corpectomy and an expandable titanium cage and lateral plate construct at T3-T5. Two months later he developed focal kyphosis and loosening of his screws. This was addressed with an instrumented posterior fusion from T1 to T8 complicated by a wound infection, pneumonia, and fungal esophagitis requiring several debridements and vacuum assisted closure therapy. Worsening back pain prompted a thoracic computed tomography scan, revealing a dissecting thoracic-aortic aneurysm, which was treated with an endovascular stent graft. Few months later, he presented with fevers, chills, and hemoptysis secondary to Staphylococcus aureus bacteremia, endovascular leak, and T3-T5 osteomyelitis. He was transferred to our institution and restented by the cardiothoracic service. Subsequently, he underwent a thoracotomy, evacuation of infected aneurysmal hematoma with removal of instrumentation. A revision corpectomy with iliac crest autograft reconstruction was performed without complications. The patient's infection and thoracic pain resolved. However, there was a significant delay in treatment, resulting in substantial morbidity. Patients with thoracic type B2 fractures require careful evaluation for concomitant aortic and visceral injuries. Missed associated injuries result in increased morbidity and mortality.
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PMID:Thoracic aortic dissection and mycotic pseudoaneurysm in the setting of an unstable upper thoracic type b2 fracture. 2435 65

We report the case of a 57-year-old woman who presented with massive hemoptysis and thoracic pain 3 years after the endovascular treatment of a thoracic aortic aneurysm. Emergency work up revealed the presence of an endoleak, leading to the pressurization of the aneurysm sac and its subsequent rupture into the lung parenchyma. The discussion includes presentation, clinical course, diagnosis, complications and new therapeutic options in the management of a massive hemoptysis secondary to aortic rupture. All together, the case and discussion highlight the classical rules of critical care and the recent advances in endovascular treatment of thoracic aortic rupture.
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PMID:[Massive hemoptysis following thoracic aortic rupture: an advancing field]. 2456 27

An aortobronchial fistula is a rare but important diagnosis, which if missed is potentially fatal. We describe a case of a man who presented with severe, spontaneous per oral bleeding. The patient believed the bleeding occurred on coughing not vomiting. Despite denying haematemesis, initial investigations were focused on excluding an upper gastrointestinal bleed because of multiple risk factors (previous alcohol dependence, recent gastritis and heavy smoking). Two urgent oesophagogastroduodenoscopys were unremarkable. A plain chest film demonstrated left-sided perihilar shadowing of possible neoplastic origin. Two days later following sudden torrential haemoptysis, an emergency CT angiogram demonstrated a descending aortic aneurysm and associated aorto-bronchial fistula. The case helps reaffirm the old aphorism that "the patient is telling you the diagnosis"--this was indeed haemoptysis not haematemesis. Despite the power of hindsight, it is a reminder that accurate history-taking is essential in selecting the best first-line investigation, particularly in cases of diagnostic uncertainty.
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PMID:Haemoptysis or haematemesis? The not so bleeding obvious. 2478 47

This 35-year-old man presented with history of hemoptysis and breathlessness on exertion of 3 months duration. Examination revealed feeble left radial, brachial and carotid pulses. Chest radiograph showed a superior mediastinal mass and contrast enhanced computed tomography chest showed a large aortic arch with mass and compression effects. Endosonographic examination was suggestive of aortic aneurysm. During further evaluation, serum Venereal Disease Research Laboratory test was found to be positive in titers of 1:32. Treponema pallidum hemagglutination test was performed and showed positive titers of 1:64. Neurosyphilis was ruled out by normal cerebrospinal fluid examination findings. Patient was treated with injectable benzathine penicillin and aortic aneurysm repair was planned. The authors present a rare case of tertiary syphilis complicated with aortic aneurysm in this era of early use of highly effective antibiotics.
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PMID:A rare case of tertiary syphilis complicated with aortic aneurysm in this era of early use of highly effective antibiotics. 2495 87


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