ABSTRACT
A massive hemothorax from a ruptured bronchial artery aneurysm (BAA) is very rare. Only 12 cases of ruptured mediastinal BAA have been reported. This case study describes a 77-year-old female with bronchiectasis who presented with anemia, hypertension, hemothorax, and a mediastinal mass. A chest tube was inserted through which 2 liters of unclotted blood was drained from the left pleural cavity. An enhanced computed tomography scan revealed a ruptured 3-cm diameter mediastinal aneurysm of a bronchial artery supplying the left lower lobe. Transcatheter artery embolization (TAE) with multiple microcoils was performed successfully. Although the patient needed a transfusion, the subsequent course was uneventful. In the absence of trauma or other causes for hemothorax and mediastinal hemorrhage, the possibility of a BAA should be considered. TAE is the treatment method of choice as a minimally invasive strategy in patients with ruptured BAA.
