Abstract
False aneurysm of the pulmonary artery complicated by bronchovascular fistula formation represents a rare life threating condition. We report a case of fatal hemoptysis after formation of a bronchial fistula in the late postoperative period after sleeve lobectomy. Cause of death was determined by external postmortem examination, post mortem computed tomography (PMCT) and angiography (PMCTA) without conventional autopsy.
Similar content being viewed by others
References
Shaaban H, Sharma H, Rao J, Clark S. A pulmonary artery false aneurysm after right middle lobectomy: a case report. J Med Case Rep. 2007;1(1):70.
Forcillo J, Liberman M, Gorgos A, Ferraro P. Repair of a bronchovascular fistula four years after right carinal pneumonectomy. Ann Thorac Surg. 2013;95(6):2152–3.
Poplausky MR, Rozenblit G, Rundback JH, Crea G, Maddineni S, Leonardo R. Swan-Ganz catheter-induced pulmonary artery pseudoaneurysm formation: three case reports and a review of the literature. Chest. 2001;120(6):2105–11.
Fliss B, Bartsch C, Flach PM, Thali MJ, Ampanozi G. Fatal aorto-esophageal fistula detected on postmortem computed tomography angiography. J Forensic Radiol Im. 2015;3(3):182–5.
Ross S, Spendlove D, Bolliger S, Christe A, Oesterhelweg L, Grabherr S, et al. Postmortem whole-body CT angiography: evaluation of two contrast media solutions. AJR. 2008;190(5):1380–9.
Grabherr S, Dominguez A, Mangin P. Post-mortem angio-CT: a new diagnostic approach. Rev Med Suisse. 2011;7(303):1507–10.
Schweitzer W, Flach PM, Thali M, Laberke P, Gascho D. Very economical immersion pump feasibility for postmortem CT angiography. J Forensic Radiol Im. 2016;5:8–14.
Chevallier C, Doenz F, Vaucher P, Palmiere C, Dominguez A, Binaghi S, et al. Postmortem computed tomography angiography vs. conventional autopsy: advantages and inconveniences of each method. Int J Legal Med. 2013;127(5):981–9.
Rashid SN, Bouwer H, O'Donnell C. Lethal hemorrhage from a ureteric-arterial-enteric fistula diagnosed by postmortem CT angiography. Forensic Sci Med Pathol. 2012;8(4):430–5.
Burton JL, Rutty GN. The hospital autopsy. In: Burton J, Rutty G, editors. The hospital autopsy. 2nd ed. London: Arnold; 2001. p. 60–77.
Coast GC, Gee DJ. Traumatic subarachnoid hemorrhage - an alternative source. J Clin Pathol. 1984;37(11):1245–8.
Maxeiner H. Detection of ruptured cerebral bridging veins at autopsy. Forensic Sci Int. 1997;89(1–2):103–10.
McLean JM, Wright RM, Henderson JP, Lister JR. Vertebral artery rupture associated with closed head injury. Report of two cases. J Neurosurg. 1985;62(1):135–8.
Karhunen PJ, Mannikko A, Penttila A, Liesto K. Diagnostic angiography in postoperative autopsies. Am J Forensic Med Pathol. 1989;10(4):303–9.
Zerlauth JB, Doenz F, Dominguez A, Palmiere C, Uske A, Meuli R, et al. Surgical interventions with fatal outcome: utility of multi-phase postmortem CT angiography. Forensic Sci Int. 2013;225(1–3):32–41.
Samano MN, Saka JA, Caramori ML, Pego-Fernandes PM, Jatene FB. Fatal bronchovascular fistula after a single lung transplantation: a case report. Clinics. 2009;64(10):1031–3.
Piciche M, De Paulis R, Fabbri A, Chiariello L. Postoperative aortic fistulas into the airways: etiology, pathogenesis, presentation, diagnosis, and management. Ann Thorac Surg. 2003;75(6):1998–2006.
Nunley DR, Gal AA, Vega JD, Perlino C, Smith P, Lawrence EC. Saprophytic fungal infections and complications involving the bronchial anastomosis following human lung transplantation. Chest. 2002;122(4):1185–91.
Sihvo EIT, Sioris T, Tynninen O, Salo JA. Fatal fistula between the trachea and the brachiocephalic artery: late complication of a second-generation, self-expanding metallic tracheal stent. J Thorac Cardiovasc Surg. 2006;131(6):1415–6.
Pirrelli S, Bozzani A, Arici V, Odero A. Endovascular treatment of acute haemoptysis secondary to aortobronchial fistula. Eur J Vasc Endovasc Surg. 2006;32(4):366–8.
Jeannin A, Saignac P, Palussiere J, Gekiere JP, Descat E, Lakdja F. Massive systemic air embolism during percutaneous radiofrequency ablation of a primary lung tumor. Anesth Analg. 2009;109(2):484–6.
Ebert LC, Ptacek W, Breitbeck R, Furst M, Kronreif G, Martinez RM, et al. Virtobot 2.0: the future of automated surface documentation and CT-guided needle placement in forensic medicine. Forensic Sci Med Pathol. 2014;10(2):179–86.
Steffen C, Schaepman M, Hardmeier T, Schweitzer W. Digital 3D reconstruction of two parahissian accessory bundles in a case of Wolff-Parkinson-White syndrome. Int J Legal Med. 2004;118(2):101–5.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
The authors express their gratitude to Emma Louise Kessler, MD for her generous donation to the Zurich Institute of Forensic Medicine, University of Zurich, Switzerland.
Conflict of interest
The authors declare no conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Rights and permissions
About this article
Cite this article
Hinderberger, P., Fliss, B., Thali, M.J. et al. Fatal bronchovascular fistula after lobectomy visualized through postmortem computed tomography angiography: A case report. Forensic Sci Med Pathol 13, 234–239 (2017). https://doi.org/10.1007/s12024-017-9867-4
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12024-017-9867-4