Korean J Med.  2016 Apr;90(4):341-345. 10.3904/kjm.2016.90.4.341.

Fatal Massive Hemoptysis Related to a Pulmonary Artery Pseudoaneurysm after Treatment of a Lung Abscess

• Bae JW
• Kim SW
• Kim YM
• Cho B
• Lee H
• Kuk KW
• Hong G

• KMID: 2268849
• DOI: http://doi.org/10.3904/kjm.2016.90.4.341

Abstract

Pulmonary artery pseudoaneurysm (PAP) is a very rare vascular abnormality and is often caused at least in part by infection. While Mycobacterium tuberculosis is a relatively common cause of PAP, it can also result from a lung abscess. Aneurysm rupture resulting in massive hemoptysis is potentially fatal, with death caused by aspiration of blood and consequent asphyxiation. We admitted a 55-year-old man with massive hemoptysis. He had been treated with intravenous antibiotics for three weeks after diagnosing a lung abscess. Contrast-enhanced chest computed tomography revealed a pseudoaneurysm inside the abscess. Diagnostic catheter pulmonary angiography confirmed the diagnosis of pseudoaneurysm of the pulmonary artery. Embolization successfully controlled the airway bleeding. However, the patient died of acute respiratory failure on the seventh hospital day. When hemoptysis is due to sustained inflammation, such as a lung abscess, bleeding from the pulmonary artery should be considered.

Keyword

Abscess; Lung; Aneurysm; Pulmonary artery; Hemoptysis

MeSH Terms

Abscess
Aneurysm
Aneurysm, False*
Angiography
Anti-Bacterial Agents
Catheters
Diagnosis
Hemoptysis*
Hemorrhage
Humans
Inflammation
Lung Abscess*
Lung*
Middle Aged
Mycobacterium tuberculosis
Pulmonary Artery*
Respiratory Insufficiency
Rupture
Thorax
Anti-Bacterial Agents