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Emergency surgery for hemothorax due to a ruptured pulmonary arteriovenous malformation

  • Jun Naito
  • Takahiro NakajimaEmail author
  • Junichi Morimoto
  • Takayoshi Yamamoto
  • Yuichi Sakairi
  • Hironobu Wada
  • Hidemi Suzuki
  • Toshihiko Sugiura
  • Koichiro Tatsumi
  • Ichiro Yoshino
Case Report

Abstract

Pulmonary arteriovenous malformation (PAVM) is a potential cause of hemothorax. The risk of PAVM rupture is reported to be higher during pregnancy for several reasons, including increased body fluid and a change in hormonal conditions. A 34-year-old pregnant woman suddenly felt right chest pain and dyspnea in the 28th week of gestation. Chest X-ray and computed tomography showed massive right pleural effusion. Her vital signs gradually deteriorated with hemorrhagic shock, necessitating emergency surgery. During exploratory thoracoscopy, active bleeding from the middle lobe was noticed and gauze packing was required to maintain her blood pressure. Following conversion to major thoracotomy, wedge resection of the middle lobe was performed with a linear stapler, and finally, her general condition became stable. Her postoperative course was uneventful. A histological examination of the resected specimen confirmed the diagnosis of ruptured PAVM. Her baby was successfully delivered at the 38th week of gestation.

Keywords

Hemothorax Pulmonary arteriovenous malformation (PAVM) Pregnancy Hereditary hemorrhagic telangiectasia (HHT) 

Notes

Compliance with ethical standards

Conflict of interest

The authors have declared that no conflict of interest exists.

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Copyright information

© The Japanese Association for Thoracic Surgery 2020

Authors and Affiliations

  • Jun Naito
    • 1
  • Takahiro Nakajima
    • 1
    Email author
  • Junichi Morimoto
    • 1
  • Takayoshi Yamamoto
    • 1
  • Yuichi Sakairi
    • 1
  • Hironobu Wada
    • 1
  • Hidemi Suzuki
    • 1
  • Toshihiko Sugiura
    • 2
  • Koichiro Tatsumi
    • 2
  • Ichiro Yoshino
    • 1
  1. 1.Department of General Thoracic Surgery, Graduate School of MedicineChiba UniversityChibaJapan
  2. 2.Department of Respiratory MedicineChiba University Graduate School of MedicineChibaJapan

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