Skip to main content
Top
Published in: Intensive Care Medicine 10/2003

01-10-2003 | Brief Report

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

Authors: Clément Picard, Antoine Parrot, Véronique Boussaud, Armelle Lavolé, Faycal Saidi, Charles Mayaud, Marie France Carette

Published in: Intensive Care Medicine | Issue 10/2003

Login to get access

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.
Literature
1.
go back to reference Middleton JR, Sen P, Lange M, Salaki J, Kapila R, Louria DB (1977) Death-producing hemoptysis in tuberculosis. Chest 72:601–604PubMed Middleton JR, Sen P, Lange M, Salaki J, Kapila R, Louria DB (1977) Death-producing hemoptysis in tuberculosis. Chest 72:601–604PubMed
2.
go back to reference Teklu B, Felleke G (1982) Massive hemoptysis in tuberculosis. Tubercle 63:213–216PubMed Teklu B, Felleke G (1982) Massive hemoptysis in tuberculosis. Tubercle 63:213–216PubMed
3.
go back to reference Ong TH, Eng P (2003) Massive hemoptysis requiring intensive care. Intensive Care Med 29:317–320PubMed Ong TH, Eng P (2003) Massive hemoptysis requiring intensive care. Intensive Care Med 29:317–320PubMed
4.
go back to reference Conlan AA, Hurwitz SS, Krige L, Nicolaou N, Pool R (1983) Massive hemoptysis. Rewiew of 123 cases. J Thorac Cardiovasc Surg 85:120–124PubMed Conlan AA, Hurwitz SS, Krige L, Nicolaou N, Pool R (1983) Massive hemoptysis. Rewiew of 123 cases. J Thorac Cardiovasc Surg 85:120–124PubMed
5.
go back to reference McCollun WB, Mattox KL, Guinn GA, Beall AC (1975) Immediate operative treatment for massive hemoptysis. Chest 67:152–155PubMed McCollun WB, Mattox KL, Guinn GA, Beall AC (1975) Immediate operative treatment for massive hemoptysis. Chest 67:152–155PubMed
6.
go back to reference Ramakantan R, Bandekar VG, Gandhi MS, Aulakh BG, Deshmukh HL (1996) Massive hemoptysis due to pulmonary tuberculosis: control with bronchial artery embolization. Radiology 200:691–694PubMed Ramakantan R, Bandekar VG, Gandhi MS, Aulakh BG, Deshmukh HL (1996) Massive hemoptysis due to pulmonary tuberculosis: control with bronchial artery embolization. Radiology 200:691–694PubMed
7.
go back to reference Auerbach O (1939) Pathology and pathogenesis of pulmonary arterial aneurysm in tuberculous cavities. Am Rev Tuber 39:99–115 Auerbach O (1939) Pathology and pathogenesis of pulmonary arterial aneurysm in tuberculous cavities. Am Rev Tuber 39:99–115
8.
go back to reference Remy-Jardin M, Wattinne L, Remy J (1991) Transcatheter occlusion of pulmonary arterial circulation and collateral supply: failures, incidents and complications. Radiology 180:699–705PubMed Remy-Jardin M, Wattinne L, Remy J (1991) Transcatheter occlusion of pulmonary arterial circulation and collateral supply: failures, incidents and complications. Radiology 180:699–705PubMed
9.
go back to reference Sanyika C, Corr P, Royston D, Blyth DF (1999) Pulmonary angiography and embolization for severe hemoptysis due to cavitary pulmonary tuberculosis. Cardiovasc Intervent Radiol 22:457–460CrossRefPubMed Sanyika C, Corr P, Royston D, Blyth DF (1999) Pulmonary angiography and embolization for severe hemoptysis due to cavitary pulmonary tuberculosis. Cardiovasc Intervent Radiol 22:457–460CrossRefPubMed
10.
go back to reference Remy J, Lemaitre L, Lafitte JJ, Vilain MO, Saint Michel J, Steenhouwer F (1984) Massive hemoptysis of pulmonary arterial origin: diagnosis and treatment. AJR 143:963–969 Remy J, Lemaitre L, Lafitte JJ, Vilain MO, Saint Michel J, Steenhouwer F (1984) Massive hemoptysis of pulmonary arterial origin: diagnosis and treatment. AJR 143:963–969
11.
go back to reference Patankar T, Prasad S, Deshmukh H, Mukherji SK (2000) Fatal hemoptysis caused by ruptured giant Rasmussen's aneurysm. AJR 174:262–263 Patankar T, Prasad S, Deshmukh H, Mukherji SK (2000) Fatal hemoptysis caused by ruptured giant Rasmussen's aneurysm. AJR 174:262–263
12.
go back to reference Santelli ED, Katz DS, Goldschmidt AM, Thomas HA (1994) Embolization of multiple Rasmussen aneurysms as a treatment of hemoptysis. Radiology 193:396–398PubMed Santelli ED, Katz DS, Goldschmidt AM, Thomas HA (1994) Embolization of multiple Rasmussen aneurysms as a treatment of hemoptysis. Radiology 193:396–398PubMed
Metadata
Title
Massive hemoptysis due to Rasmussen aneurysm: detection with helicoidal CT angiography and successful steel coil embolization
Authors
Clément Picard
Antoine Parrot
Véronique Boussaud
Armelle Lavolé
Faycal Saidi
Charles Mayaud
Marie France Carette
Publication date
01-10-2003
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 10/2003
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-003-1912-y

Other articles of this Issue 10/2003

Intensive Care Medicine 10/2003 Go to the issue