Advertisement

Intensive Care Medicine

, Volume 29, Issue 10, pp 1837–1839 | Cite as

Massive hemoptysis due to Rasmussen aneurysm: detection with helicoidal CT angiography and successful steel coil embolization

  • Clément Picard
  • Antoine Parrot
  • Véronique Boussaud
  • Armelle Lavolé
  • Faycal Saidi
  • Charles Mayaud
  • Marie France Carette
Brief Report

Abstract

Objective

To present the successful management of two cases of massive hemoptysis related to pulmonary aneurysms in patients with active tuberculosis.

Design and setting

Retrospective study in the respiratory intensive care unit (ICU) of a university hospital.

Patients

Between July 1996 and January 2002, 46 cases of hemoptysis related to active tuberculosis needed ICU admission. In two cases, pulmonary aneurysm was the source of bleeding.

Results

Diagnosis was suspected on enhanced CT scan and confirmed by pulmonary angiograms. Transcatheter occlusion of pulmonary arterial circulation was successful. Both patients were alive at 1-year follow-up.

Conclusions

Massive hemoptysis occurring in patients with active tuberculosis could arise from pulmonary aneurysms. In such cases, bronchial artery embolization is ineffective. Before referring those patients for emergency surgery, an alternative strategy using angiographic study and transcatheter occlusion of pulmonary arterial circulation might be of interest.

Keywords

Massive hemoptysis Rasmussen aneurysm Embolization Vaso-occlusion of the pulmonary artery 

References

  1. 1.
    Middleton JR, Sen P, Lange M, Salaki J, Kapila R, Louria DB (1977) Death-producing hemoptysis in tuberculosis. Chest 72:601–604PubMedGoogle Scholar
  2. 2.
    Teklu B, Felleke G (1982) Massive hemoptysis in tuberculosis. Tubercle 63:213–216PubMedGoogle Scholar
  3. 3.
    Ong TH, Eng P (2003) Massive hemoptysis requiring intensive care. Intensive Care Med 29:317–320PubMedGoogle Scholar
  4. 4.
    Conlan AA, Hurwitz SS, Krige L, Nicolaou N, Pool R (1983) Massive hemoptysis. Rewiew of 123 cases. J Thorac Cardiovasc Surg 85:120–124PubMedGoogle Scholar
  5. 5.
    McCollun WB, Mattox KL, Guinn GA, Beall AC (1975) Immediate operative treatment for massive hemoptysis. Chest 67:152–155PubMedGoogle Scholar
  6. 6.
    Ramakantan R, Bandekar VG, Gandhi MS, Aulakh BG, Deshmukh HL (1996) Massive hemoptysis due to pulmonary tuberculosis: control with bronchial artery embolization. Radiology 200:691–694PubMedGoogle Scholar
  7. 7.
    Auerbach O (1939) Pathology and pathogenesis of pulmonary arterial aneurysm in tuberculous cavities. Am Rev Tuber 39:99–115Google Scholar
  8. 8.
    Remy-Jardin M, Wattinne L, Remy J (1991) Transcatheter occlusion of pulmonary arterial circulation and collateral supply: failures, incidents and complications. Radiology 180:699–705PubMedGoogle Scholar
  9. 9.
    Sanyika C, Corr P, Royston D, Blyth DF (1999) Pulmonary angiography and embolization for severe hemoptysis due to cavitary pulmonary tuberculosis. Cardiovasc Intervent Radiol 22:457–460CrossRefPubMedGoogle Scholar
  10. 10.
    Remy J, Lemaitre L, Lafitte JJ, Vilain MO, Saint Michel J, Steenhouwer F (1984) Massive hemoptysis of pulmonary arterial origin: diagnosis and treatment. AJR 143:963–969Google Scholar
  11. 11.
    Patankar T, Prasad S, Deshmukh H, Mukherji SK (2000) Fatal hemoptysis caused by ruptured giant Rasmussen's aneurysm. AJR 174:262–263Google Scholar
  12. 12.
    Santelli ED, Katz DS, Goldschmidt AM, Thomas HA (1994) Embolization of multiple Rasmussen aneurysms as a treatment of hemoptysis. Radiology 193:396–398PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Clément Picard
    • 1
  • Antoine Parrot
    • 1
  • Véronique Boussaud
    • 1
  • Armelle Lavolé
    • 1
  • Faycal Saidi
    • 1
  • Charles Mayaud
    • 1
  • Marie France Carette
    • 2
  1. 1.Service de Réanimation Respiratoire et de PneumologieHôpital TenonParisFrance
  2. 2.Service de RadiologieHôpital TenonParisFrance

Personalised recommendations