A rare presentation of a ruptured bronchial artery aneurysm
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1 Department of Cardiothoracic Surgery, Northern General Hospital, Sheffield S5 7AU, UK
2 Department of Vascular Radiology, Northern General Hospital, Sheffield S5 7AU, UK
3 Department of Cardiothoracic Surgery, Northern General Hospital, Sheffield S5 7AU, UK
Correspondence to:
Mr S Ghosh
Department of Cardiothoracic Surgery, Northern General Hospital, Sheffield S5 7AU, UK; sudip.ghosh@talk21.com
A fit 59 year old man with no past medical history of respiratory diseases presented with chest pain and bilateral pleural effusions. On arrival at the specialist thoracic unit his haemoglobin was 7.2 g/l. A CT scan (fig 1) and selective arteriography (fig 2) confirmed an acute bilateral haemothorax secondary to a ruptured bronchial artery aneurysm of the distal segment of the right bronchial artery just below the level of the carina. The patient was treated with bilateral intercostal chest drainage and the aneurysm was successfully treated with coil embolisation. He was discharged home on day 8 and a repeat CT scan before his discharge revealed almost total regression of the haemothoraces and no enhancement of the aneurysm.
Figure 1 Contrast enhanced CT scan at the subcarinal level showing a focal round area of increased attenuation (arrow) adjacent to the bronchus intermedius.
Figure 2 Selective arteriogram of the right bronchial artery showing a saccular aneurysm arising from the distal segment of the right bronchial artery.(A Chatterjee1, S Ghosh1, )
2 Department of Vascular Radiology, Northern General Hospital, Sheffield S5 7AU, UK
3 Department of Cardiothoracic Surgery, Northern General Hospital, Sheffield S5 7AU, UK
Correspondence to:
Mr S Ghosh
Department of Cardiothoracic Surgery, Northern General Hospital, Sheffield S5 7AU, UK; sudip.ghosh@talk21.com
A fit 59 year old man with no past medical history of respiratory diseases presented with chest pain and bilateral pleural effusions. On arrival at the specialist thoracic unit his haemoglobin was 7.2 g/l. A CT scan (fig 1) and selective arteriography (fig 2) confirmed an acute bilateral haemothorax secondary to a ruptured bronchial artery aneurysm of the distal segment of the right bronchial artery just below the level of the carina. The patient was treated with bilateral intercostal chest drainage and the aneurysm was successfully treated with coil embolisation. He was discharged home on day 8 and a repeat CT scan before his discharge revealed almost total regression of the haemothoraces and no enhancement of the aneurysm.
Figure 1 Contrast enhanced CT scan at the subcarinal level showing a focal round area of increased attenuation (arrow) adjacent to the bronchus intermedius.
Figure 2 Selective arteriogram of the right bronchial artery showing a saccular aneurysm arising from the distal segment of the right bronchial artery.(A Chatterjee1, S Ghosh1, )