Hemoptisis amenazante y arteria bronquial aberrante / Life threatening hemoptysis and aberrant bronchial artery. A case report

La hemoptisis y hemorragia pulmonar son infrecuentes en edad pediátrica pero pueden presentarse como una emergencia respiratoria de riesgo vital o bien ser manifestación de patología grave. Se describe el caso de una niña de 11 años que presentó 4 episodios de 50ml en 48h de sangre roja brillante, sin antecedentes de patología respiratoria recurrente ni traumatismos. Una evaluación mediante radiografía de tórax, broncoscopia y angiotomografía computarizada (angio-TC) fundamentan el diagnostico del origen de la hemorragia. La angio-TC objetivó como fuente de la hemoptisis una arteria bronquial hipertrofiada con origen anómalo en el arco aórtico adyacente a la arteria subclavia derecha aberrante. El tratamiento se realizó mediante embolización selectiva del vaso sangrante con microesferas de polivinilo de 500-700μm y la resolución fue satisfactoria. No hubo complicaciones. La embolización de arteria bronquial es un procedimiento eficaz y las complicaciones son infrecuentes en manos expertas (AU)

Hemoptysis and pulmonary hemorrhage are rare pathological entities in childhood, however, both can be life threatening respiratory emergencies and can signify potentially serious underlying intrathoracic disease. We report an 11 year old female who had four episodes of hemoptysis (50mL of bright red blood within 48hours) without previous recurrent respiratory problems. The assessment by chest radiography, bronchoscopy and computed tomography (CT) was needed to diagnose the nature of the problem and to indicate the site and extent of the bleeding. The CT angiography of the thorax showed a right bronchial artery hypertrophy, abnormally originated from the aortic arch, next to an aberrant right subclavian artery. The bleeding was successfully controlled by right bronchial arterial embolization with 500-700μm polyvinyl alcohol (PVA) microspheres. The course was uncomplicated. The bronchial artery embolization is effective in controlling hemoptysis and complications are uncommon in the hand of an experienced operator (AU)

[Life threatening hemoptysis and aberrant bronchial artery. A case report]. / Hemoptisis amenazante y arteria bronquial aberrante.

Hemoptysis and pulmonary hemorrhage are rare pathological entities in childhood, however, both can be life threatening respiratory emergencies and can signify potentially serious underlying intrathoracic disease. We report an 11 year old female who had four episodes of hemoptysis (50 mL of bright red blood within 48 hours) without previous recurrent respiratory problems. The assessment by chest radiography, bronchoscopy and computed tomography (CT) was needed to diagnose the nature of the problem and to indicate the site and extent of the bleeding. The CT angiography of the thorax showed a right bronchial artery hypertrophy, abnormally originated from the aortic arch, next to an aberrant right subclavian artery. The bleeding was successfully controlled by right bronchial arterial embolization with 500-700 µm polyvinyl alcohol (PVA) microspheres. The course was uncomplicated. The bronchial artery embolization is effective in controlling hemoptysis and complications are uncommon in the hand of an experienced operator.

[Renal echographic volumetry in the child. Normal patterns]. / Volumetría ecográfica renal en el niño. I. Patrones normales.

After experimental verification of an excellent correlation between volume measurements by water displacement and echography we have checked that there were no differences among several renal measurements performed in children by the same person. In our normal population of 313 children we assumed that the best correlation between somatometric and renal measurements parameter was between weight and renal volume. We have developed volumetric growth charts for both kidneys. There were no significant difference between right and left kidney.