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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of massive endobronchial hemorrhage following a fistula formation of the right pulmonary artery to the right mainstem bronchus in a 15-year-old girl. The fistula had occurred 39 days after the patient had undergone bilateral lung transplantation for cystic fibrosis. The post-transplantation course was remarkable for bronchial colonization by Aspergillus at the site of right bronchial anastomosis and an episode of spontaneous, self-limited hemoptysis on postoperative day 17. A massive endobronchial hemorrhage during surveillance bronchoscopy occurred 39 days after transplantation. Immediate intervention, including rigid bronchoscopy followed by surgery, was effective in saving the patient. The pathophysiologic hypothesis to explain the fistula of the right pulmonary artery to the right mainstem bronchus probably involves ischemia of the anastomosis with necrosis of the suture zone complicated by endobronchial infection with Aspergillus. Rigid bronchoscopic intervention associated with an excellent medical surgical collaboration was pivotal in successfully rescuing the patient.
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PMID:Management of an intrabronchial rupture of right main pulmonary artery: a case report. 1188 88

We report a case of a 41-year-old woman who underwent therapeutic embolization of an aberrant systemic artery of the lung. Except for chest pains immediately after embolization, she recovered well and has not experienced hemoptysis in the past 6 years. In such patients, coil embolization could be an alternative choice of treatment, with the expectation of an excellent long-term result despite ischemia of the corresponding lung parenchyma.
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PMID:Systemic arterial supply to the normal basal segments of the left lower lobe treated by coil embolization, with long-term follow-up. 1695 15

A 63-year-old man who had underwent video-assisted thoracoscopic bullectomy for left spontaneous pneumothorax 1 year before developed recurrent hemoptysis. Chest computed tomography showed previous stapling of the subsegmental bronchus in the left apico-posterior segment Bronchial arteriography showed hypervascularization of bronchial artery in the left upper segment and pooling of contrast medium along the staple-suture line. Video-assisted thoracoscopic apico-posterior segmentectomy was performed successfully. Pathological examination revieled hemosiderin lining along the surgical stump of B(1+2)cii, neither with infection nor infarction. These findings suggest that mechanical stapling of B(1+2)cii induced ischemia in the peripheral lung parenchyma causing bronchial hypervascularization. Late onset hemoptysis should be kept in mind as a complication after bullectomy with a mechanical stapler.
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PMID:[Hemoptysis one year after video-assisted thoracoscopic bullectomy for spontaneous pneumothorax: report of a case]. 1841 1

Bronchial artery aneurysm (BAA) is a rare clinical entity. A case of intrapulmonary BAA associated with previous bronchotomy at the same site is described. A 22-year-old woman, who had undergone bronchotomy of the intermediate bronchus for the removal of a foreign body four years previously, presented with recurrent hemoptysis. Because of an increased risk for spinal cord ischemia, she immediately underwent lung resection rather than therapeutic embolization. The incidental finding of a BAA of any cause cannot be assumed to be stable, and immediate management should be undertaken regardless of the presence or absence of symptoms.
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PMID:Recurrent massive hemoptysis due to postbronchotomy bronchial artery aneurysm: a case report. 1843 53

Massive hemoptysis is a life-threatening emergency. Chest radiograph, computed tomography, and bronchoscopy play a complementary role in diagnosing the underlying cause of hemorrhage and localizing the bleeding site. Bronchial artery embolization remains the primary and most effective method in controlling massive hemoptysis. Bronchial and nonbronchial systemic arteries are the main source of bleeding and are embolized with polyvinyl alcohol particles or gelatin sponge. Immediate cessation of bleeding occurs in more than 75% of patients; however, long-term recurrences are common in patients with progressive lung disease. Complications are infrequent except for a rare occurrence of spinal cord ischemia.
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PMID:Bronchial artery embolization. 1985 30

Bronchial artery embolization was attempted several times in a 74-year-old man undergoing right pneumonectomy for persistent hemoptysis. Paraplegia developed after surgery. Both thoracotomy for lung surgery and bronchial artery embolization have been reported to cause spinal cord ischemia. We analyze the possible mechanisms through which such ischemia may develop.
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PMID:[Spinal cord ischemia after bronchial artery embolization and right thoracotomy]. 2011 47

A 48-year-old smoker and alcoholic patient was admitted for life-threatening hemoptysis. The admission bronchoscopy showed a tumoral mass almost occluding the right bronchus intermedious. During the procedure the patient developed massive bleeding and underwent selective aortic angiogram and coiling of 2 bronchial arteries. After the patient stabilized, a contrast thoracic computed tomography was performed, revealing a right pulmonary artery pseudoaneurysm. On the basis of that finding, a selective right pulmonary artery angiogram was performed, showing a 3.4-cm-diameter pseudoaneurysm that was embolized. Hemoptysis resolved after the procedure, but the patient developed parenchymal ischemia-infarct on the treated area (right lower lobe). A pulmonary artery pseudoaneurysm can arise from a lung tumor and cause massive hemoptysis. Although unusual, ischemia and infarct can occur after embolotherapy.
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PMID:Pulmonary artery pseudoaneurysm arising from a lung tumor. 2316 93

Bronchovascular fistula is a rare but serious complication that usually presents with massive hemoptysis and is associated with a high risk of mortality. Factors leading to the development of the fistula include altered bronchial anastomotic healing, presence of granulation tissue, devascularization of the bronchial tree, ischemia of the airway, and poor anastomotic technique. Bronchovascular fistulae usually occur in the early postoperative period and are reported in 1% to 3% of the patients undergoing a bronchoplastic procedure. We report the case of a 53-year-old woman who presented with massive hemoptysis secondary to a bronchovascular fistula 4 years after right carinal pneumonectomy.
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PMID:Repair of a bronchovascular fistula four years after right carinal pneumonectomy. 2370 34

Acute life-threatening conditions in oncology patients may develop either because of underlying malignancy or as a complication from treatment. Oncologic emergencies can be categorized as metabolic, hematologic, and structural conditions. Metabolic and hematologic emergencies are mainly diagnosed on the basis of clinical and laboratory findings. Structural pathologic conditions that result in bleeding, mechanical compression, or obstruction to the hollow organs, such as the trachea and bowel loops, may first be suspected because of clinical findings, including decreasing hematocrit levels, difficulty in breathing, and abdominal pain; however, performance of imaging studies is critical for timely diagnosis and management. Life-threatening conditions of the central nervous system (such as cerebral herniation, carcinomatous meningitis, and spinal cord compression), thoracic emergent conditions (such as central airway obstruction, esophagorespiratory fistula, massive hemoptysis, pulmonary embolism, superior vena cava syndrome, and pericardial tamponade), and abdominopelvic emergencies (such as uncontrolled intraabdominal hemorrhage, bowel obstruction, intestinal perforation, bowel ischemia, intussusception, and urinary tract obstruction) can be definitively diagnosed on the basis of projectional or cross-sectional imaging findings in appropriate clinical scenarios. Select emergent conditions in cancer patients related to chemotherapy and radiation treatment, as well as iatrogenic emergencies secondary to either surgery or placement of central venous catheters, may also demonstrate characteristic findings at imaging studies. In addition, interventional procedures are of great help in the treatment of acute superior vena cava syndrome, massive hemoptysis, and uncontrolled intraabdominal hemorrhage. Radiologists should be aware of these select, "not to be missed" imaging findings of oncologic emergencies to make an accurate, timely diagnosis and provide appropriate patient care.
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PMID:Imaging of oncologic emergencies: what every radiologist should know. 2410 50

A 74-year-old female patient was admitted to hospital following a road accident with pains in the chest, abdomen, waist, back, nose, left wrist and lower limbs. After 1 week, the patient presented with gastrointestinal bleeding, and thus was treated with protein pump inhibitors (PPIs), including lansoprazole, esomeprazole and omeprazole enteric-coated tablets, in order to inhibit acid secretion and attenuate bleeding. However, the patient developed skin rashes on the chest and right lower limb and foot 28 days following treatment initiation. The skin rashes spread and ulcerated after 3 days, and were associated with tracheal mucosal injury and hemoptysis. Subsequently, treatment of the patient with PPIs was terminated, after which the tracheal hemoptysis and skin rashes markedly improved. In addition, no new skin rashes appeared following termination of the PPI treatment. In the present case, long-term treatment of an elderly patient with PPIs may have induced exfoliative dermatitis, due to hepatic ischemia, hypoxia and acute renal failure, which may have decreased the metabolism of PPIs, resulting in the accumulation of PPI metabolites.
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PMID:Proton pump inhibitor-induced exfoliative dermatitis: A case report. 2689 44


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