Pulmonary ligament rupture due to a bronchial artery aneurysm-induced hematoma: a case report
Abstract Background Bronchial artery aneurysm (BAA) is a rare vascular anomaly with the potential for serious complications, such as rupture leading to hemothorax or hemoptysis. Although bronchial artery embolization (BAE) is recognized as an effective intervention for ruptured BAA, video-assisted t...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2024-01-01
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| Series: | Surgical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40792-024-01810-3 |
| _version_ | 1797355589181898752 |
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| author | Yasuaki Tomioka Eiji Yamada Tsuyoshi Hyodo Masahiko Muro |
| author_facet | Yasuaki Tomioka Eiji Yamada Tsuyoshi Hyodo Masahiko Muro |
| author_sort | Yasuaki Tomioka |
| collection | DOAJ |
| description | Abstract Background Bronchial artery aneurysm (BAA) is a rare vascular anomaly with the potential for serious complications, such as rupture leading to hemothorax or hemoptysis. Although bronchial artery embolization (BAE) is recognized as an effective intervention for ruptured BAA, video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach for the treatment of associated hemothorax. Case presentation A 73-year-old woman presented with a mediastinal hematoma from a ruptured BAA, causing bilateral hemothorax. Emergency angiography revealed a saccular BAA that was successfully embolized using a microcatheter and coil. Subsequent computed tomography revealed an expanding hemothorax managed by VATS, with 1400 mL of blood drained. During VATS, thoracoscopy revealed pulmonary ligament rupture, which was attributed to increased intramediastinal pressure. The patient was discharged eight days postoperatively with no complications. This case highlights the use of BAE and VATS in the management of mediastinal BAA rupture and massive hemothorax. Conclusions BAE proved to be an effective strategy for the management of ruptured mediastinal BAAs. VATS is a valuable standby procedure for hematoma removal, but the indication should be carefully determined because of the risk of BAA re-rupture. |
| first_indexed | 2024-03-08T14:13:18Z |
| format | Article |
| id | doaj.art-8f0130e9846e4011bcbf2a448e7f5006 |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-03-08T14:13:18Z |
| publishDate | 2024-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-8f0130e9846e4011bcbf2a448e7f50062024-01-14T12:34:22ZengSpringerOpenSurgical Case Reports2198-77932024-01-011011410.1186/s40792-024-01810-3Pulmonary ligament rupture due to a bronchial artery aneurysm-induced hematoma: a case reportYasuaki Tomioka0Eiji Yamada1Tsuyoshi Hyodo2Masahiko Muro3Division of Thoracic Surgery, Department of Surgery, Fukuyama City HospitalDivision of Thoracic Surgery, Department of Surgery, Fukuyama City HospitalDivision of Radiology, Department of Diagnostic Radiology and Interventional Radiology, Fukuyama City HospitalDivision of Thoracic Surgery, Department of Surgery, Fukuyama City HospitalAbstract Background Bronchial artery aneurysm (BAA) is a rare vascular anomaly with the potential for serious complications, such as rupture leading to hemothorax or hemoptysis. Although bronchial artery embolization (BAE) is recognized as an effective intervention for ruptured BAA, video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach for the treatment of associated hemothorax. Case presentation A 73-year-old woman presented with a mediastinal hematoma from a ruptured BAA, causing bilateral hemothorax. Emergency angiography revealed a saccular BAA that was successfully embolized using a microcatheter and coil. Subsequent computed tomography revealed an expanding hemothorax managed by VATS, with 1400 mL of blood drained. During VATS, thoracoscopy revealed pulmonary ligament rupture, which was attributed to increased intramediastinal pressure. The patient was discharged eight days postoperatively with no complications. This case highlights the use of BAE and VATS in the management of mediastinal BAA rupture and massive hemothorax. Conclusions BAE proved to be an effective strategy for the management of ruptured mediastinal BAAs. VATS is a valuable standby procedure for hematoma removal, but the indication should be carefully determined because of the risk of BAA re-rupture.https://doi.org/10.1186/s40792-024-01810-3Bronchial artery aneurysmBronchial artery embolizationChest and back painMediastinal hematomaMassive hemothoraxRupture |
| spellingShingle | Yasuaki Tomioka Eiji Yamada Tsuyoshi Hyodo Masahiko Muro Pulmonary ligament rupture due to a bronchial artery aneurysm-induced hematoma: a case report Surgical Case Reports Bronchial artery aneurysm Bronchial artery embolization Chest and back pain Mediastinal hematoma Massive hemothorax Rupture |
| title | Pulmonary ligament rupture due to a bronchial artery aneurysm-induced hematoma: a case report |
| title_full | Pulmonary ligament rupture due to a bronchial artery aneurysm-induced hematoma: a case report |
| title_fullStr | Pulmonary ligament rupture due to a bronchial artery aneurysm-induced hematoma: a case report |
| title_full_unstemmed | Pulmonary ligament rupture due to a bronchial artery aneurysm-induced hematoma: a case report |
| title_short | Pulmonary ligament rupture due to a bronchial artery aneurysm-induced hematoma: a case report |
| title_sort | pulmonary ligament rupture due to a bronchial artery aneurysm induced hematoma a case report |
| topic | Bronchial artery aneurysm Bronchial artery embolization Chest and back pain Mediastinal hematoma Massive hemothorax Rupture |
| url | https://doi.org/10.1186/s40792-024-01810-3 |
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