Massive Pulmonary Hemorrhage from Bronchial Varix
Bronchial varix is a rare pulmonary disorder which may lead to life-threatening hemorrhage. Diagnosis is difficult because of the subtle abnormalities on radiographic and bronchoscopic examination. We present a case of massive hemoptysis from a bleeding bronchial varix. In the absence of immediate c...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Case Reports in Pulmonology |
| Online Access: | http://dx.doi.org/10.1155/2020/9175785 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832560651568939008 |
|---|---|
| author | Michael Agustin Scott Shay Jose Gonzalez Pei Liu Nancy Lentz Anna Shapiro Nat Dumrongmongcolgul Michael Torres Vasin Jungtrakoolchai |
| author_facet | Michael Agustin Scott Shay Jose Gonzalez Pei Liu Nancy Lentz Anna Shapiro Nat Dumrongmongcolgul Michael Torres Vasin Jungtrakoolchai |
| author_sort | Michael Agustin |
| collection | DOAJ |
| description | Bronchial varix is a rare pulmonary disorder which may lead to life-threatening hemorrhage. Diagnosis is difficult because of the subtle abnormalities on radiographic and bronchoscopic examination. We present a case of massive hemoptysis from a bleeding bronchial varix. In the absence of immediate complex endobronchial therapy in the island of Guam, this case was initially managed with nebulized and intravenous tranexamic acid. This was followed by endobronchial blockade of the bleeding airway with endobronchial epinephrine instillation. Selective bronchial artery embolization alleviated the acute-phase bleeding. Prone positioning was initiated due to severe hypoxia after blood clots compromised the patency of bilateral bronchial airways. Prone ventilation was employed for 17 hours for 2 consecutive days with intermittent bronchoscopic forceps extraction of airway blood clots while in the prone position. These maneuvers resulted to improved lung ventilation and oxygenation. The patient underwent bronchial sleeve resection surgery for definitive management. |
| format | Article |
| id | doaj-art-25810c5b260441ee991d26f38efc2bef |
| institution | Kabale University |
| issn | 2090-6846 2090-6854 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pulmonology |
| spelling | doaj-art-25810c5b260441ee991d26f38efc2bef2025-02-03T01:26:58ZengWileyCase Reports in Pulmonology2090-68462090-68542020-01-01202010.1155/2020/91757859175785Massive Pulmonary Hemorrhage from Bronchial VarixMichael Agustin0Scott Shay1Jose Gonzalez2Pei Liu3Nancy Lentz4Anna Shapiro5Nat Dumrongmongcolgul6Michael Torres7Vasin Jungtrakoolchai8Guam Regional Medical City Intensive Care Unit, 133 Route 3, 96929 Dededo, Guam, USAGuam Regional Medical City Intensive Care Unit, 133 Route 3, 96929 Dededo, Guam, USAGuam Regional Medical City Intensive Care Unit, 133 Route 3, 96929 Dededo, Guam, USAGuam Regional Medical City Intensive Care Unit, 133 Route 3, 96929 Dededo, Guam, USAGuam Regional Medical City Intensive Care Unit, 133 Route 3, 96929 Dededo, Guam, USAGuam Regional Medical City Intensive Care Unit, 133 Route 3, 96929 Dededo, Guam, USAGuam Regional Medical City Intensive Care Unit, 133 Route 3, 96929 Dededo, Guam, USAGuam Regional Medical City Intensive Care Unit, 133 Route 3, 96929 Dededo, Guam, USAGuam Regional Medical City Intensive Care Unit, 133 Route 3, 96929 Dededo, Guam, USABronchial varix is a rare pulmonary disorder which may lead to life-threatening hemorrhage. Diagnosis is difficult because of the subtle abnormalities on radiographic and bronchoscopic examination. We present a case of massive hemoptysis from a bleeding bronchial varix. In the absence of immediate complex endobronchial therapy in the island of Guam, this case was initially managed with nebulized and intravenous tranexamic acid. This was followed by endobronchial blockade of the bleeding airway with endobronchial epinephrine instillation. Selective bronchial artery embolization alleviated the acute-phase bleeding. Prone positioning was initiated due to severe hypoxia after blood clots compromised the patency of bilateral bronchial airways. Prone ventilation was employed for 17 hours for 2 consecutive days with intermittent bronchoscopic forceps extraction of airway blood clots while in the prone position. These maneuvers resulted to improved lung ventilation and oxygenation. The patient underwent bronchial sleeve resection surgery for definitive management.http://dx.doi.org/10.1155/2020/9175785 |
| spellingShingle | Michael Agustin Scott Shay Jose Gonzalez Pei Liu Nancy Lentz Anna Shapiro Nat Dumrongmongcolgul Michael Torres Vasin Jungtrakoolchai Massive Pulmonary Hemorrhage from Bronchial Varix Case Reports in Pulmonology |
| title | Massive Pulmonary Hemorrhage from Bronchial Varix |
| title_full | Massive Pulmonary Hemorrhage from Bronchial Varix |
| title_fullStr | Massive Pulmonary Hemorrhage from Bronchial Varix |
| title_full_unstemmed | Massive Pulmonary Hemorrhage from Bronchial Varix |
| title_short | Massive Pulmonary Hemorrhage from Bronchial Varix |
| title_sort | massive pulmonary hemorrhage from bronchial varix |
| url | http://dx.doi.org/10.1155/2020/9175785 |
| work_keys_str_mv | AT michaelagustin massivepulmonaryhemorrhagefrombronchialvarix AT scottshay massivepulmonaryhemorrhagefrombronchialvarix AT josegonzalez massivepulmonaryhemorrhagefrombronchialvarix AT peiliu massivepulmonaryhemorrhagefrombronchialvarix AT nancylentz massivepulmonaryhemorrhagefrombronchialvarix AT annashapiro massivepulmonaryhemorrhagefrombronchialvarix AT natdumrongmongcolgul massivepulmonaryhemorrhagefrombronchialvarix AT michaeltorres massivepulmonaryhemorrhagefrombronchialvarix AT vasinjungtrakoolchai massivepulmonaryhemorrhagefrombronchialvarix |