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1.
An. bras. dermatol ; 96(2): 240-242, Mar.-Apr. 2021. graf
Article in English | LILACS | ID: biblio-1248742

ABSTRACT

Abstract Small vessel vasculitis with anti-proteinase antibodies 3 is an atypical clinical presentation of tuberculosis. The authors present the case of a 47-year-old male patient, with palpable purpura and palmoplantar hemorrhagic blisters, with subsequent dissemination. He presented severe pulmonary symptoms with cavitation, fever, hemoptysis, and high levels of anti-proteinase 3. Histopathological assessment of the skin revealed small vessel vasculitis; pulmonary histopathology showed granulomas with caseation. Bronchoalveolar lavage was positive for alcohol-acid-fast bacilli. In countries with a high prevalence of tuberculosis, the presence of autoantibodies in a patient with vasculitis, fever, and pulmonary cavitation requires investigation of infectious causes.


Subject(s)
Vasculitis/diagnosis , Skin Diseases, Vascular , Antibodies, Antineutrophil Cytoplasmic , Myeloblastin , Hemoptysis/diagnosis , Hemoptysis/etiology , Lung/diagnostic imaging , Middle Aged
2.
J. bras. pneumol ; 47(4): e20200557, 2021. tab, graf
Article in English | LILACS | ID: biblio-1286951

ABSTRACT

ABSTRACT Objective: Massive hemoptysis is one of the most serious complications in patients with cystic fibrosis (CF). This study aimed to evaluate the hemoptysis-free period following bronchial and non-bronchial artery embolization (BAE/non-BAE) in CF patients and to investigate predictors of recurrent bleeding and mortality by any cause. Methods: This was a retrospective cohort study of CF patients ≥ 16 years of age undergoing BAE/non-BAE for hemoptysis between 2000 and 2017. Results: We analyzed 39 hemoptysis episodes treated with BAE/non-BAE in 17 CF patients. Hemoptysis recurrence rate was 56.4%. Of the sample as a whole, 3 (17.6%) were hemoptysis-free during the study period, 2 (11.8%) underwent lung transplantation, and 3 (17.6%) died. The median hemoptysis-free period was 17 months. The median hemoptysis-free period was longer in patients with chronic infection with Pseudomonas aeruginosa (31 months; 95% CI: 0.00-68.5) than in those without that type of infection (4 months; 95% CI: 1.8-6.2; p = 0.017). However, this association was considered weak, and its clinical significance was uncertain due to the small number of patients without that infection. Conclusions: BAE appears to be effective in the treatment of hemoptysis in patients with CF.


RESUMO Objetivo: A hemoptise maciça é uma das complicações mais graves em pacientes com fibrose cística (FC). O objetivo deste estudo foi avaliar o período livre de hemoptise após a embolização arterial brônquica/não brônquica (EAB/não EAB) em pacientes com FC e investigar preditores de sangramento recorrente e mortalidade por qualquer causa. Métodos: Trata-se de um estudo retrospectivo de coorte de pacientes com FC com idade ≥ 16 anos submetidos a EAB/não EAB para o tratamento de hemoptise entre 2000 e 2017. Resultados: Foram analisados 39 episódios de hemoptise tratada por meio de EAB/não EAB em 17 pacientes com FC. A taxa de recidiva da hemoptise foi de 56,4%. Do total de pacientes, 3 (17,6%) permaneceram sem hemoptise durante o estudo, 2 (11,8%) foram submetidos a transplante de pulmão e 3 (17,6%) morreram. A mediana do período sem hemoptise foi de 17 meses. A mediana do período sem hemoptise foi maior em pacientes com infecção crônica por Pseudomonas aeruginosa (31 meses; IC95%: 0,00-68,5) do que naqueles sem esse tipo de infecção (4 meses; IC95%: 1,8-6,2; p = 0,017). No entanto, essa associação foi considerada fraca, e sua importância clínica foi considerada incerta em virtude do pequeno número de pacientes sem essa infecção. Conclusões: A EAB parece ser eficaz no tratamento de hemoptise em pacientes com FC.


Subject(s)
Humans , Cystic Fibrosis/complications , Cystic Fibrosis/therapy , Embolization, Therapeutic , Bronchial Arteries , Retrospective Studies , Treatment Outcome , Hemoptysis/etiology , Hemoptysis/therapy
3.
Medwave ; 21(1): e8112, 2021.
Article in English, Spanish | LILACS | ID: biblio-1283299

ABSTRACT

El pseudoaneurisma se define como un hematoma pulsátil repermeabilizado, encapsulado y en comunicación con la luz de un vaso dañado. Se origina cuando hay una disrupción de la pared arterial. La hemoptisis es un signo/síntoma de presentación muy rara de aneurisma aórtico torácico y de pseudoaneurisma aórtico torácico. Hay poca información sobre la hemoptisis asociada con la ruptura del aneurisma aórtico cuyo mecanismo no se explica por la presencia de una fístula aortopulmonar. Entre las hipótesis para explicar este fenómeno, se encuentra la capacidad de las arterias bronquiales de volverse hiperplásicas y tortuosas en presencia de una lesión que modifica la arquitectura pulmonar, siendo más susceptibles a la ruptura. También hay descripciones de lesiones directas del parénquima pulmonar por aneurisma roto. El presente caso nos ilustra que debemos considerar a la hemoptisis como signo de alarma en el diagnóstico diferencial de los aneurismas y pseudoaneurismas aórticos entre otras causas que puede ser fatal en breve tiempo por una hemorragia masiva.


Pseudoaneurysm is defined as a reperfused pulsatile hematoma, encapsulated and communicated with the damaged vessel's lumen. It originates when there is a disruption of the arterial wall. Hemoptysis is a very rare sign/symptom of a thoracic aortic aneurysm or pseudoaneurysm. There is little information on hemoptysis associated with aortic aneurysm rupture, whose mechanisms are not explained by the presence of an aortopulmonary fistula. Among the hypotheses to explain this phenomenon, is the ability of the bronchial arteries to become hyperplasic and tortuous in the presence of a lesion that modifies the pulmonary architecture, being more susceptible to rupture. There are also descriptions of direct lung parenchymal injury from ruptured aneurysm. The present case illustrates that we must consider the hemoptysis as a warning sign in differential diagnosis of aortic aneurysms and pseudo aneurysms, among other causes, that it can be fatal in a short time due to massive hemorrhage.


Subject(s)
Humans , Male , Aged, 80 and over , Aorta, Thoracic/diagnostic imaging , Aortic Rupture , Aortic Aneurysm, Thoracic/diagnostic imaging , Aneurysm, False/diagnostic imaging , Hemoptysis/etiology , Tomography, X-Ray , Aortic Aneurysm, Thoracic/surgery , Aortic Aneurysm, Thoracic/complications , Aneurysm, False/surgery , Aneurysm, False/complications , Diagnosis, Differential , Computed Tomography Angiography , Hemoptysis/diagnosis
4.
Neumol. pediátr. (En línea) ; 16(1): 48-52, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1284224

ABSTRACT

Unilateral agenesis of the pulmonary artery is a rare malformation, sometimes asymptomatic and underdiagnosed. Right agenesis is usually isolated, while the left agenesis is more frequently associated with cardiovascular malformations. Some patients have recurrent respiratory infections, exercise limitation, hemoptysis, and/or pulmonary hypertension. The diagnosis is suspected by chest radiograph showing a hypoplastic lung ipsilateral to the agenesis. It is confirmed with contrast-enhanced chest computed tomography. In asymptomatic patients, management should be conservative, however, the search for collateral vessels should be started from adolescence, because they can bleed. In symptomatic patients or those with serious complications, the treatment must be interventional. The objective of this article is to present two patients with right and left pulmonary artery agenesis respectively and review the literature.


La agenesia unilateral de la arteria pulmonar es una malformación poco frecuente, en ocasiones asintomática y subdiagnosticada. La agenesia derecha suele ser aislada, en cambio la izquierda se asocia más frecuentemente a malformaciones cardiovasculares. Algunos pacientes presentan infecciones respiratorias recurrentes, limitación al ejercicio, hemoptisis y/o hipertensión pulmonar. El diagnóstico se sospecha al solicitar una radiografía de tórax que muestra un pulmón hipoplásico ipsilateral a la agenesia. Se confirma con tomografía computada de tórax con contraste. En pacientes asintomáticos el manejo debe ser conservador, sin embargo, se debe iniciar la búsqueda de vasos colaterales especialmente durante la adolescencia, los que pueden sangrar. En cambio, en los pacientes sintomáticos o que presentan complicaciones graves, el tratamiento debe ser intervencional. El objetivo de este trabajo es presentar a dos pacientes con agenesia de la arteria pulmonar derecha e izquierda respectivamente y hacer una revisión de la literatura.


Subject(s)
Humans , Male , Adolescent , Pulmonary Artery/abnormalities , Pulmonary Artery/diagnostic imaging , Radiography, Thoracic , Tomography, X-Ray Computed , Hemoptysis/etiology
5.
Medicina (B.Aires) ; 80(6): 640-648, dic. 2020. graf
Article in Spanish | LILACS | ID: biblio-1250286

ABSTRACT

Resumen Se presentan los resultados de 105 pacientes con hemoptisis amenazante tratados mediante embolización arterial por cateterismo percutáneo por vía arterial sistémica y/o arterial pulmonar. Se describe la técnica del procedimiento y los hallazgos angiográficos. Se muestra la utilidad de la fibrobroncoscopía y de la radiografía de tórax para identificar la zona sangrante como diagnóstico previo al procedimiento. Entre mayo 2000 y septiembre 2015 se admitieron en el Servicio de Hemodinamia 105 pacientes con diagnóstico de hemoptisis amenazante, 76 masculinos (72.4%); edad media: 41 (±18.65 DS) años. El 93% (98/105) fue tratado con éxito. En el 90% (88/98) se efectuó embolización por arterias bronquiales y/o no bronquiales sistémicas y en el 10% (10/98) por vía arterial pulmonar. Cuando la afección era bilateral la angiografía sola no posibilitó identificar el sitio de sangrado. Al 60% (63/98) se le hizo fibrobroncoscopía flexible y se pudo ubicar el pulmón sangrante en el 84% (56/63). Cuando la afección era unilateral, la radiografía de tórax previa al procedimiento facilitó la ubicación del área de sangrado en el 47%. No se observaron complicaciones graves ni muertes vinculadas al procedimiento. El tratamiento de la hemoptisis masiva por vía percutánea tiene alto porcentaje de éxito primario con muy baja tasa de complicaciones. El tratamiento por vía arterial pulmonar es un abordaje alternativo. La fibrobroncoscopía flexible es un importante complemento en esta entidad.


Abstract We present the results of 105 patients with life-threatening hemoptysis who were treated with the systemic arterial and/or pulmonary artery routes. We also describe the procedure techniques and the angiographic findings. We show the usefulness of the flexible fiberoptic bronchoscopy and chest radiography to identify the bleeding zone previous to the procedure. From May 2000 to September 2015, a total of 105 patients were admitted to the Catheterization Laboratory with a diagnosis of life-threatening hemoptysis; 76 were male (72.4%) and mean age was 41 ± 18.65 years. Treatment was successful in 93% (98/105). In 90% (88/98) the approach was via the bronchial arteries and/or non-bronchial systemic arteries, and in 10% (10/98) the approach was via the pulmonary artery. In bilateral affection angiographic images alone could not identify accurately the site of the lung bleeding. Flexible fibrobronchoscopy was performed in 60% (63/98) and located the bleeding area in 84% (56/63). In unilateral affection, chest radiography previous to the procedure located the bleeding area in 47%. No complications or death were related to the procedure. The treatment of life threatening hemoptysis by a percutaneous way has a high percentage of primary success with a very low incidence of complications. Pulmonary arterial route treatment is an alternative approach. Flexible fibrobronchoscopy is an important complement to this entity.


Subject(s)
Humans , Male , Adult , Middle Aged , Young Adult , Embolization, Therapeutic , Hemoptysis/etiology , Hemoptysis/therapy , Pulmonary Artery/diagnostic imaging , Bronchial Arteries/diagnostic imaging , Angiography
6.
Neumol. pediátr. (En línea) ; 15(3): 406-410, sept. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1127613

ABSTRACT

We present the case-report of a one-month-old infant, admitted to the Emergency Department with hypovolemic shock secondary to pulmonary hemorrhage who required life-support measures, including vasoactive drugs and methylprednisolone pulses. She was discharged from the hospital after 13 days of evolution and then readmitted 5 days later for a new episode of hemoptysis with hemodynamic compromise. Fiberoptic bronchoscopy was performed 4 days after the first episode showed a normal anatomy, without active bleeding, with 20% of hemosiderophages in bronchoalveolar lavage. Diffuse infiltrates were found on the chest radiograph. Differents studies were performed for check-out infection, heart disease, immune disease, thrombophilia, celiac disease, swallowing disorder, vascular abnormalities and allergy to cow's milk protein were negative, which led to Idiopathic Pulmonary Hemosiderosis (IPH). It was managed with amino acid formula, daily oral prednisone until 6 months of age and then every other day, and permanent inhaled fluticasone. In subsequent controls, normal growth and development were found, with no recurrences up to the time of this report, at 1 year of age. The favorable evolution in this case is attributed to early diagnosis and timely treatment with systemic corticosteroids. A review of the topic of IPH in pediatrics is presented, and study and treatment algorithms are proposed.


Se presenta el caso de una lactante de un mes de edad, que se presentó en el Servicio de Urgencia con shock hipovolémico secundario a hemorragia pulmonar. Necesitó medidas de soporte vital, incluyendo drogas vasoactivas y pulsos de metilprednisolona. Egresó del hospital a los 13 días de evolución y reingresó 5 días después por nuevo episodio de hemoptisis con compromiso hemodinámico. La fibrobroncoscopía efectuada a los 4 días de evolución del primer episodio mostró una anatomía normal, sin sangrado activo, con 20% de hemosiderófagos en el lavado broncoalveolar. En la radiografía de tórax se encontró infiltrados difusos. Los estudios en busca de infección, cardiopatía, enfermedad inmunológica, trombofilia, enfermedad celíaca, trastorno de deglución, anomalías vasculares y alergia a la proteína de la leche de vaca resultaron negativos, por lo que se planteó una Hemosiderosis Pulmonar Idiopática (HPI). Se manejó con fórmula aminoacídica, prednisona oral diaria hasta los 6 meses de edad y después en días alternos y fluticasona inhalada permanente. En controles posteriores se constató crecimiento y desarrollo normal, sin recidivas hasta el momento de este reporte, con 1 año de edad. La evolución favorable en este caso se atribuye al diagnóstico precoz y tratamiento oportuno con corticoides sistémicos. Se presenta una revisión del tema de HPI en pediatría y se proponen algoritmos de estudio y tratamiento.


Subject(s)
Humans , Female , Infant, Newborn , Hemosiderosis/drug therapy , Hemosiderosis/diagnostic imaging , Methylprednisolone , Prednisone , Radiography, Thoracic , Adrenal Cortex Hormones/therapeutic use , Fluticasone , Hemoptysis/etiology , Hemosiderosis/complications
8.
Arch. argent. pediatr ; 116(3): 455-458, jun. 2018. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-950026

ABSTRACT

El blastoma pleuropulmonar corresponde a una neoplasia primaria de pulmón, exclusiva de la edad pediátrica, poco frecuente y de características agresivas. La edad de diagnóstico varía entre 1 mes y 12 años. No se identifica una distinción de sexos. Se localiza en la pleura o el pulmón. Suele presentarse como dificultad respiratoria, con o sin neumotórax, dolor torácico y fiebre, por lo que es mal diagnosticada como neumonía. Radiológicamente, suele hallarse una masa de gran tamaño cercana a la pleura en la base pulmonar derecha sin broncograma aéreo. Cuenta con tres tipos histológicos: tipo I (quístico), tipo II (mixto), tipo III (sólido). Su tratamiento incluye resección y quimioterapia multimodal. El tipo I tiene un pronóstico favorable, pero los tipos II y III tienen mal pronóstico. Se presenta un caso de blastoma pleuropulmonar en una niña de 2 años, con énfasis en su diagnóstico clínico-radiológico.


Pleuropulmonary Blastoma corresponds to a malignant primary lung disorder, exclusive of pediatric age, infrequent and of aggressive characteristics. Age on diagnosis is 1 month-12 years. Rates per sex are equal. It can be found inside pleura or lungs. Respiratory distress associated or not with pneumothorax, chest pain and fever are classical clinical signs. These symptoms could be misdiagnosed as pneumonia. Radiologically, a large mass near the pleura at the base of the right lung without air bronchogram is its most common form. It has three histological types: type I (cystic), type II (mixed) and type III (solid). Its treatment requires tumor excision and multimodal chemotherapy. Pleuropulmonary Blastoma type I has good prognosis; type II and III variants have lower survival. We report a 2-year-old girl, pointing to the clinical-radiological diagnosis.


Subject(s)
Humans , Female , Child, Preschool , Pulmonary Blastoma/diagnosis , Cough/etiology , Hemoptysis/etiology , Prognosis , Survival , Pulmonary Blastoma/physiopathology , Pulmonary Blastoma/diagnostic imaging
9.
Rev. bras. ginecol. obstet ; 40(5): 300-303, May 2018. graf
Article in English | LILACS | ID: biblio-958987

ABSTRACT

Abstract Thoracic endometriosis syndrome is a rare condition that includes four entities: catamenial pneumothorax, catamenial hemothorax, catamenial hemoptysis and lung nodules. We describe the case of a 23-year-old woman with complaints of hemoptysis during menstrual period in the two years prior to the appointment. Initially, a treatment for tuberculosis was established with no success. Further investigation showed a 4 mmnodule in the right lung, and the transvaginal ultrasonography indicated the presence of deep endometriosis. Considering the occurrence of symptoms only during menses, an empirical therapy was instituted with remission of the complaints.


Resumo A síndrome da endometriose torácica é uma condição rara que inclui quatro entidades: pneumotórax catamenial, hemotórax catamenial, hemoptise catamenial e nódulos pulmonares. Descrevemos o caso de umamulher de 23 anos de idade comqueixas de hemoptise durante o período menstrual por 2 anos. Inicialmente, um tratamento para a tuberculose foi estabelecido sem sucesso. Uma investigação adicional mostrou um nódulo de 4 mm no pulmão direito, e a ultrassonografia transvaginal indicou a presença de endometriose profunda. Considerando a ocorrência de sintomas somente durante a menstruação, uma terapia empírica foi instituída com remissão das queixas.


Subject(s)
Humans , Female , Young Adult , Endometriosis/complications , Hemoptysis/etiology , Lung Diseases/complications , Syndrome
11.
Rev. méd. Chile ; 146(4): 528-533, abr. 2018. graf
Article in Spanish | LILACS | ID: biblio-961425

ABSTRACT

Arterial involvement in Behçet's disease (BD) is less common than venous lesions. The most commonly affected arteries are: the aorta, lower extremity arteries, mesenteric, femoral, coronary, renal, subclavian and pulmonary arteries. The rupture of pulmonary arteries is the main cause of death of patients with EB and the presence of aneurysms is a bad prognostic factor. We report two patients with arterial involvement in BD. A 14 years old male presenting with hemoptysis lasting three days. A chest computed tomography showed an aneurismal dilatation of the right interlobar artery, bilateral intramural thrombi and alveolar hemorrhage. A right lobar pulmonary resection was performed but hemoptysis recurred. Suspecting a BD, prednisone was started and hemoptysis subsided. A 42 years old male presenting with chest pain and hemoptysis. A chest CT scan showed thrombi in pulmonary veins and anticoagulant therapy was started. Two months later he was admitted again due to a massive hemoptysis. The CT scan showed aneurisms in pulmonary arteries, mural thrombi and pulmonary infarction. With the diagnosis of BD, methylprednisolone, followed by prednisone and cyclophosphamide were used, with a good clinical response.


Subject(s)
Humans , Male , Adolescent , Adult , Pulmonary Artery/diagnostic imaging , Behcet Syndrome/complications , Hemoptysis/etiology , Tomography, X-Ray Computed , Behcet Syndrome/drug therapy , Behcet Syndrome/diagnostic imaging , Glucocorticoids/therapeutic use
12.
Rev. bras. ter. intensiva ; 30(1): 116-120, jan.-mar. 2018. graf
Article in Portuguese | LILACS | ID: biblio-899564

ABSTRACT

RESUMO A oxigenação por membrana extracorpórea tem sido utilizada para tratamento de hipoxemia refratária em muitos cenários clínicos. Os princípios fundamentais do manejo do paciente com hemoptise maciça são a proteção da via aérea e do pulmão sadio, a localização da fonte de sangramento e o controle da hemorragia. Relatamos o caso de uma paciente com insuficiência respiratória aguda associada à hemoptise maciça secundária à laceração pulmonar durante cirurgia cardíaca. O uso da oxigenação por membrana extracorpórea venoarterial permitiu a sobrevivência da paciente, porém, devido à grande dificuldade no manejo dos coágulos pulmonares após hemoptise, foi necessário o uso de terapia incomum, com infusão endobrônquica de trombolítico, conforme descrito em raros casos na literatura.


ABSTRACT Extracorporeal membrane oxygenation has been used to treat refractory hypoxemia in numerous clinical scenarios. The fundamental principles for the management of massive hemoptysis patients include protecting the airway and healthy lung, locating the source of bleeding and controlling the hemorrhage. We report the case of a patient with acute respiratory failure associated with massive hemoptysis secondary to lung laceration during cardiac surgery. The use of extracorporeal membrane oxygenation allowed patient survival. However, due to the great difficulty in managing pulmonary clots after hemoptysis, it was necessary to use an unusual therapy involving endobronchial infusion of a thrombolytic agent as described in rare cases in the literature.


Subject(s)
Humans , Female , Extracorporeal Membrane Oxygenation/methods , Fibrinolytic Agents/administration & dosage , Hemoptysis/therapy , Postoperative Complications/physiopathology , Postoperative Complications/therapy , Respiratory Insufficiency/etiology , Respiratory Insufficiency/therapy , Acute Disease , Cardiac Surgical Procedures/adverse effects , Hemoptysis/etiology , Middle Aged
13.
Rev. méd. Chile ; 145(1): 131-134, ene. 2017. ilus
Article in Spanish | LILACS | ID: biblio-845513

ABSTRACT

IgG4 disease is a multi-systemic condition involving pancreas, salivary glands and lymph nodes. Less frequently, it causes interstitial nephritis and involves the lungs. We report a 58 years old male with a four years history of hemoptysis and renal dysfunction characterized by hematuria and proteinuria, responsive to steroidal therapy. The renal biopsy established the diagnosis of IgG4 associated interstitial nephritis. Lung involvement was considered secondary to the same systemic disease.


Subject(s)
Humans , Male , Middle Aged , Autoimmune Diseases/complications , Immunoglobulin G , Hemoptysis/etiology , Nephritis, Interstitial/complications , Nephritis, Interstitial/diagnosis , Recurrence , Autoimmune Diseases/diagnosis , Diagnosis, Differential , Hemoptysis/diagnosis
14.
Rev. méd. Chile ; 144(11): 1417-1423, nov. 2016. ilus, tab
Article in Spanish | LILACS | ID: biblio-845463

ABSTRACT

Background: Central airway obstruction caused by malignant or benign lesions, associated in some cases with hemoptysis, is a condition with high morbidity and mortality. The use of electrocautery by flexible bronchoscopy is an initial treatment option with immediate improvement of obstruction symptoms. It is as effective as Nd: YAG laser. Aim: To describe the usefulness of electrocautery in the management of central obstruction of the airway and hemoptysis. Material and Methods: A retrospective, descriptive study of patients referred for management of central airway obstruction or associated hemoptysis. Diagnoses, symptoms (dyspnea, cough, and hemoptysis) and radiology before and after the procedures were analyzed. Results: Eighteen patients aged 59 ± 12 years (66% males) were evaluated, registering 25 endoscopic procedures. Three conditions were found: partial or complete airway obstruction, hemoptysis and post lung transplant bronchial stenosis. Seventy two percent presented with dyspnea, 61% with cough and 33% with hemoptysis. Sixty six percent of patients had airway obstruction caused by malignant metastatic lesions. After electrocautery, 17 patients (94.4%) improved their symptoms and achieved complete airway clearing. Three patients had significant bronchial stenosis after lung transplant achieving subsequent clearing after electrocautery. Conclusions: Electrocautery during flexible bronchoscopy is an effective and safe procedure for the management of central airway obstruction and associated hemoptysis.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Bronchoscopy/methods , Airway Obstruction/surgery , Electrocoagulation/methods , Hemoptysis/surgery , Bronchi/surgery , Bronchi/physiopathology , Reproducibility of Results , Retrospective Studies , Treatment Outcome , Disease Management , Cough , Airway Obstruction/etiology , Dyspnea , Lasers, Solid-State , Hemoptysis/etiology , Lung Neoplasms/complications
16.
Medicina (B.Aires) ; 75(2): 95-98, abr. 2015. ilus
Article in Spanish | LILACS | ID: lil-750521

ABSTRACT

El síndrome de Hughes-Stovin es una entidad infrecuente caracterizada por trombosis venosa profunda y aneurismas de la arteria pulmonar, siendo su etiología y patogenia desconocida. Algunos autores la consideran una variante de la enfermedad de Behcet. Su curso natural es generalmente fatal. Se presenta con tos, disnea, hemoptisis, dolor torácico y fiebre. El tratamiento es con esteroides y agentes citotóxicos hasta la cirugía. Presentamos el caso de un hombre de 41 años que consultó por disnea, hemoptisis y dolor torácico, llegándose al diagnóstico de trombosis venosa profunda de miembro inferior derecho, trombo-embolismo de pulmón y aneurismas de arterias pulmonares. Recibió tratamiento con corticoides en altas dosis y 6 pulsos de ciclofosfamida de 1 gramo durante 6 meses, con regresión completa de los aneurismas y de la sintomatología.


The Hughes-Stovin syndrome is a rare entity characterized by deep vein thrombosis and pulmonary artery aneurysms of unknown etiology and pathogenesis. Some authors considered a variant of Behcet's disease. Its natural course is usually fatal. The symptoms are cough, dyspnea, hemoptysis, chest pain and fever. The treatment goes from steroids and cytotoxic agents to surgery. We present the case of a 41 year old man who shows dyspnea, hemoptysis, and chest pain leading to the diagnosis of deep venous thrombosis of the right leg, lung thromboembolism and pulmonary artery aneurysms. He was treated with high-dose corticosteroids and 6 cyclophosphamide pulses of 1 gram each per 6 months with complete regression of aneurysms and symptomatology.


Subject(s)
Humans , Male , Adult , Pulmonary Artery , Pulmonary Embolism/diagnosis , Aneurysm, Ruptured/diagnosis , Venous Thrombosis/diagnosis , Syndrome , Behcet Syndrome/diagnosis , Hemoptysis/etiology
17.
Rev. ANACEM (Impresa) ; 8(2): 57-60, dic. 2014. ilus
Article in Spanish | LILACS | ID: biblio-997674

ABSTRACT

INTRODUCCIÓN: Las fístulas aortobronquiales son una causa muy infrecuente de hemoptisis masiva. Se asocia a la presencia de un aneurisma aórtico, y su evolución es siempre letal sin un tratamiento oportuno. El objetivo es presentar un caso de fístula aortobronquial y la revisión de bibliografía respectiva. Presentación del caso: Paciente de género femenino, de 76 años, hipertensa y diabética, sin otros antecedentes mórbidos. Ingresó al Servicio de Urgencia por hemoptisis posterior a caída a nivel. La radiografía de tórax mostró imagen hiperdensa en vértice pulmonar izquierdo, asociada a desviación mediastínica contralateral. Evolucionó con episodio de hemoptisis masiva el cual fue tratado satisfactoriamente con reposición de volumen y transfusión de hemoderivados. La tomografía computada de tórax con contraste mostró aneurisma de aorta torácica, de diámetro máximo de 10,8 cm...


INTRODUCTION: Aortobronchial fistula is a very rare cause of massive hemoptysis. It is associated with the presence of an aortic aneurysm and its evolution is always fatal without prompt treatment. The objective is to present a case of aortobronchial fistula and to review the respective literature. Case Report: A 76 years old woman, hypertensive and diabetic, no other known morbid history. She was admitted to emergency room with mild hemoptysis after a fall. Chest X-ray showed hyperdense image in the left lung apex, associated with contralateral mediastinal shift. She was treated with antibiotics and antitussives. She evolved with an episode of massive hemoptysis which was successfully treated with fluid resuscitation and blood transfusion. Chest computed tomography showed large thoracic aortic aneurysm with a maximum diameter of 10.8 cm…


Subject(s)
Humans , Aortic Aneurysm , Aortic Aneurysm/complications , Vascular Fistula , Vascular Fistula/complications , Hemoptysis/etiology , Tomography, X-Ray Computed , Bronchial Fistula , Bronchial Fistula/complications , Fatal Outcome
18.
Article in English | IMSEAR | ID: sea-154433

ABSTRACT

Embryonal cell carcinoma affects young males in the prime of their life with majority of tumours already having metastasised at the time of diagnosis. Subcutaneous metastasis from embryonal carcinoma is rare and is associated with widespread disease and poor prognosis. We report a case of 22-year-old male who presented with haemoptysis and skin nodules. Fine needle aspiration cytology of skin nodules and the lung lesion led to the diognosis of testicular embryonal cell carcinoma.


Subject(s)
Bone Neoplasms/secondary , Carcinoma, Embryonal/diagnosis , Carcinoma, Embryonal/pathology , Hemoptysis/etiology , Humans , Lung Neoplasms/secondary , Male , Testicular Neoplasms/diagnosis , Testicular Neoplasms/pathology , Young Adult
20.
Biomédica (Bogotá) ; 33(1): 28-33, ene.-mar. 2013.
Article in Spanish | LILACS | ID: lil-675128

ABSTRACT

Se presenta el caso de una paciente joven con hemoptisis masiva por tuberculosis que no pudo ser controlada de forma efectiva con la inserción de un catéter Fogarty por un fibrobroncoscopio. Ante esto y el alto riesgo de asfixia o desangramiento, se decidió infundir fibrinógeno-trombina a través de un catéter, introducido por el fibrobroncoscopio; con esto se logró controlar el sangrado, intubarla con un tubo orotraqueal de doble luz y estabilizarla para remitirla a otra institución, donde fue sometida a lobectomía y se le proporcionó tratamiento antituberculoso. La infusión de fibrinógeno-trombina podría considerarse como una opción terapéutica transitoria, de tipo puente, mientras se practica el manejo definitivo.


This article presents the case of a young woman with massive hemoptysis (1,000 mL in 6 hours) due to tuberculosis, which could not be controlled by insertion of a Fogarty catheter through a fiber-optic bronchoscope. Because of asphyxia and persistent bleeding risk we instilled fibrinogen-thrombin through a fiber-optic bronchoscope inserted catheter, achieving bleeding cessation and permitting the placing of a double-lumen oro-tracheal tube. Later on, the patient underwent lobectomy and anti-tuberculosis treatment. The fibrinogen-thrombin could be considered as a bridge, transitory measure for massive hemoptysis, while definitive treatment could be established.


Subject(s)
Adult , Female , Humans , Aprotinin/therapeutic use , Factor XIII/therapeutic use , Fibrin Tissue Adhesive/therapeutic use , Fibrinogen/therapeutic use , Hemostatic Techniques , Hemoptysis/therapy , Thrombin/therapeutic use , Antitubercular Agents/therapeutic use , Aprotinin/administration & dosage , Balloon Occlusion , Bronchoscopy/methods , Catheters , Combined Modality Therapy , Cholangiopancreatography, Endoscopic Retrograde/instrumentation , Drug Combinations , Emergencies , Fiber Optic Technology , Factor XIII/administration & dosage , Fibrin Tissue Adhesive/administration & dosage , Fibrinogen/administration & dosage , Hemoptysis/etiology , Hemoptysis/surgery , Hemostatic Techniques/instrumentation , Intubation, Intratracheal/instrumentation , Pneumonectomy , Thrombin/administration & dosage , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/surgery
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