Pulmonary arteriovenous malformation diagnosed by recurrent hemothorax – A case report

Background: A pulmonary arteriovenous malformation (PAVM) is an abnormal connection between a pulmonary artery and vein that causes various complications owing to a right-to-left shunt. However, hemorrhagic complications developing from a PAVM are rare. Case report: We report the case of a 61-year-o...

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Main Authors: Toshiki Sakuma, Hajime Kasai, Toshihiko Sugiura, Kenichiro Takeda, Minori Watanabe, Kenichi Suzuki, Takashi Urushibara, Takuji Suzuki
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Respiratory Medicine Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213007125000401
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author Toshiki Sakuma
Hajime Kasai
Toshihiko Sugiura
Kenichiro Takeda
Minori Watanabe
Kenichi Suzuki
Takashi Urushibara
Takuji Suzuki
author_facet Toshiki Sakuma
Hajime Kasai
Toshihiko Sugiura
Kenichiro Takeda
Minori Watanabe
Kenichi Suzuki
Takashi Urushibara
Takuji Suzuki
author_sort Toshiki Sakuma
collection DOAJ
description Background: A pulmonary arteriovenous malformation (PAVM) is an abnormal connection between a pulmonary artery and vein that causes various complications owing to a right-to-left shunt. However, hemorrhagic complications developing from a PAVM are rare. Case report: We report the case of a 61-year-old woman with a PAVM complicated by hemothorax. She had a history of right hemothorax with no identifiable cause during pregnancy 35 years prior to presentation. Although the PAVM had been identified on chest computed tomography two months previously, the patient was observed. She visited a nearby hospital with back pain and dyspnea without any inciting factor nor history of trauma. Contrast-enhanced chest CT showed a PAVM in the posterior segment of the right upper lobe and another in the apical-posterior segment of the left upper lobe. Detailed examinations suggested both past and present hemothorax due to rupture of the PAVM close to the pleura of the right upper lobe. As there was no progression of the presumed hemothorax during the index hospitalization, the patient was managed conservatively. After the hemothorax resolved, the patient underwent elective coil embolization at our facility. No recurrence of hemothorax was observed over a 10-month follow-up period. Conclusion: A PAVM can cause recurrent hemothorax, and should be considered when evaluating a patient with hemothorax. If the cause of the hemothorax cannot be identified, a PAVM may become apparent after a long period of time.
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spelling doaj-art-0fccce936302483d8e4cfe729fe7bf032025-08-20T02:15:16ZengElsevierRespiratory Medicine Case Reports2213-00712025-01-015510220410.1016/j.rmcr.2025.102204Pulmonary arteriovenous malformation diagnosed by recurrent hemothorax – A case reportToshiki Sakuma0Hajime Kasai1Toshihiko Sugiura2Kenichiro Takeda3Minori Watanabe4Kenichi Suzuki5Takashi Urushibara6Takuji Suzuki7Department of Respirology, Chiba University Hospital, Chiba, 260-8677, Japan; Corresponding author.Department of Respirology, Chiba University Hospital, Chiba, 260-8677, Japan; Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, 260-8670, JapanDepartment of Respirology, Chiba University Hospital, Chiba, 260-8677, JapanDepartment of Respirology, Chiba University Hospital, Chiba, 260-8677, JapanDepartment of Respirology, Kimitsu Chuo Hospital, Chiba, 292-0822, JapanDepartment of Respirology, Kimitsu Chuo Hospital, Chiba, 292-0822, JapanDepartment of Respirology, Kimitsu Chuo Hospital, Chiba, 292-0822, JapanDepartment of Respirology, Graduate School of Medicine, Chiba University, Chiba, 260-8670, JapanBackground: A pulmonary arteriovenous malformation (PAVM) is an abnormal connection between a pulmonary artery and vein that causes various complications owing to a right-to-left shunt. However, hemorrhagic complications developing from a PAVM are rare. Case report: We report the case of a 61-year-old woman with a PAVM complicated by hemothorax. She had a history of right hemothorax with no identifiable cause during pregnancy 35 years prior to presentation. Although the PAVM had been identified on chest computed tomography two months previously, the patient was observed. She visited a nearby hospital with back pain and dyspnea without any inciting factor nor history of trauma. Contrast-enhanced chest CT showed a PAVM in the posterior segment of the right upper lobe and another in the apical-posterior segment of the left upper lobe. Detailed examinations suggested both past and present hemothorax due to rupture of the PAVM close to the pleura of the right upper lobe. As there was no progression of the presumed hemothorax during the index hospitalization, the patient was managed conservatively. After the hemothorax resolved, the patient underwent elective coil embolization at our facility. No recurrence of hemothorax was observed over a 10-month follow-up period. Conclusion: A PAVM can cause recurrent hemothorax, and should be considered when evaluating a patient with hemothorax. If the cause of the hemothorax cannot be identified, a PAVM may become apparent after a long period of time.http://www.sciencedirect.com/science/article/pii/S2213007125000401Pulmonary arteriovenous malformationsHemothoraxEmbolizationComplication
spellingShingle Toshiki Sakuma
Hajime Kasai
Toshihiko Sugiura
Kenichiro Takeda
Minori Watanabe
Kenichi Suzuki
Takashi Urushibara
Takuji Suzuki
Pulmonary arteriovenous malformation diagnosed by recurrent hemothorax – A case report
Respiratory Medicine Case Reports
Pulmonary arteriovenous malformations
Hemothorax
Embolization
Complication
title Pulmonary arteriovenous malformation diagnosed by recurrent hemothorax – A case report
title_full Pulmonary arteriovenous malformation diagnosed by recurrent hemothorax – A case report
title_fullStr Pulmonary arteriovenous malformation diagnosed by recurrent hemothorax – A case report
title_full_unstemmed Pulmonary arteriovenous malformation diagnosed by recurrent hemothorax – A case report
title_short Pulmonary arteriovenous malformation diagnosed by recurrent hemothorax – A case report
title_sort pulmonary arteriovenous malformation diagnosed by recurrent hemothorax a case report
topic Pulmonary arteriovenous malformations
Hemothorax
Embolization
Complication
url http://www.sciencedirect.com/science/article/pii/S2213007125000401
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