Acute Respiratory Failure Caused by Hepatopulmonary Fistula in a Patient with Hepatocellular Carcinoma / 결핵및호흡기질환
Tuberculosis and Respiratory Diseases
;
: 179-183, 2016.
Article
in English
| WPRIM
| ID: wpr-197489
ABSTRACT
A 59-year-old man presented with acute dyspnea following sudden productive cough and expectoration of a full cup of "blood-tinged" sputum. He had been diagnosed with hepatitis B virus-related hepatocellular carcinoma and had received transarterial chemoembolization 5 years ago for a 20-cm hepatic mass; he denied any history of hematemesis and the last esophagogastroduodenoscopy from a year ago showed absence of varix. Chest computed tomography (CT) with angiography showed new appearance of right basal lung consolidation but no bleeding focus. Despite the use of systemic antibiotics, the patient developed respiratory failure on day 7 of hospitalization. After intubation, a massive amount of brown sputum with anchovy-paste-like consistency was suctioned via the endotracheal tube. Bronchoscopic toileting was performed and the patient was extubated. In the ward, he continued to expectorate the brown sputum. On day 25 of hospitalization, a repeat CT scan showed simultaneous disappearance of the pneumonic consolidation and the necrotic fluid within the hepatic mass, suggesting the presence of a fistula. He has continued to receive systemic antibiotics, sorafenib, and entecavir, and follow up by respiratory and hepato-oncology specialists.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pneumonia
/
Respiratory Insufficiency
/
Specialization
/
Sputum
/
Suction
/
Thorax
/
Varicose Veins
/
Angiography
/
Tomography, X-Ray Computed
/
Hematemesis
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Tuberculosis and Respiratory Diseases
Year:
2016
Type:
Article
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