1/30. Haemoptysis after breath-hold diving.Pulmonary oedema has been described in swimmers and self-contained underwater breathing apparatus (Scuba) divers. This study reports three cases of haemoptysis secondary to alveolar haemorrhage in breath-hold divers. Contributory factors, such as haemodynamic modifications secondary to immersion, cold exposure, exercise and exposure to an increase in ambient pressure, could explain this type of accident. Furthermore, these divers had taken aspirin, which may have aggravated the bleeding.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/30. Fatal haemorrhage from Dieulafoy's disease of the bronchus.A 70 year old woman with a previous history of healed tuberculosis and suspected chronic obstructive pulmonary disease presented with recurrent haemoptysis and respiratory failure from a lobar pneumonia. Massive bleeding occurred when biopsy specimens were taken during bronchoscopy which was managed conservatively, but later there was a fatal rebleed from the same site. Two different Dieulafoy's vascular malformations were found in the bronchial tree at necropsy, one of which was the biopsied lesion in the left upper lobe. This report confirms the possibility that vascular lesions occur in the bronchial tree. It is suggested that, if such lesions are suspected at bronchoscopy, bronchial and pulmonary arteriography with possible embolotherapy should be performed.- - - - - - - - - - ranking = 4keywords = haemorrhage (Clic here for more details about this article) |
3/30. Fatal pulmonary haemorrhage during anaesthesia for bronchial artery embolization in cystic fibrosis.Three children with cystic fibrosis (CF) had significant pulmonary haemorrhage during anaesthetic induction prior to bronchial artery embolization (BAE). Haemorrhage was associated with rapid clinical deterioration and subsequent early death. We believe that the stresses associated with intermittent positive pressure ventilation (IPPV) were the most likely precipitant to rebleeding and that the inability to clear blood through coughing was also an important factor leading to deterioration. Intermittent positive pressure ventilation should be avoided when possible in children with CF with recent significant pulmonary haemorrhage.- - - - - - - - - - ranking = 6keywords = haemorrhage (Clic here for more details about this article) |
4/30. Lateral thoracic artery embolization in cystic fibrosis.We report the embolization of an aberrant origin of haemoptysis - from the internal branch of the lateral thoracic artery - in a patient affected by cystic fibrosis. The technical implications for embolotheraphy in case of an aberrant origin of a haemorrhage are emphasized. Many different systemic arteries may contribute to the blood supply of the lung and many connections may exist between the systemic, bronchial and pulmonary circulations. The presence of non-bronchial systemic arteries supply should be investigated when inconclusive findings are seen during bronchial artery embolization for haemoptysis.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
5/30. A case of pulmonary haemorrhage following jet ventilation for vocal cord surgery.INTRODUCTION: This case report highlights haemoptysis occurring after post-extubation laryngospasm. CLINICAL PICTURE: General anaesthesia using Sanders jet ventilation with a Benjamin tube was administered for a patient undergoing vocal cord biopsy. He developed laryngospasm followed by significant pulmonary haemorrhage and widespread crepitations in the lung. TREATMENT: Laryngospasm was aborted with assisted ventilation with oxygen 100% via bag and mask. OUTCOME: Oxygenation was well maintained with nasal prongs only postoperatively and haemoptysis resolved after 2 days. CONCLUSION: It is imperative to prevent laryngospasm from occurring and swift action must be taken to avoid pulmonary haemorrhage.- - - - - - - - - - ranking = 6keywords = haemorrhage (Clic here for more details about this article) |
6/30. Haemoptysis in a patient with tetralogy of fallot: a combined surgical and interventional approach.Haemoptysis may occur in patients with tetralogy of fallot and major aorto-pulmonary collateral arteries. We describe such a patient in whom bleeding from a major aorto-pulmonary collateral artery produced severe pulmonary haemorrhage. Interventional closure of the artery could not be performed because it perfused the native pulmonary arteries. Instead, we inserted a conduit between the right ventricle and the native pulmonary arteries, followed by percutaneous closure of the collateral artery. Our patient demonstrates the increasing necessity for combined surgical and interventional procedures.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
7/30. Papillary fibroelastoma of the tricuspid valve presenting as neonatal pulmonary haemorrhage.Papillary fibroelastoma is a benign tumour of the cardiac valve apparatus. We present an unusual case of life-threatening pulmonary haemorrhage and disseminated intravascular coagulation in a neonate associated with this benign cardiac tumour. Papillary fibroelastoma of the tricuspid valve rarely presents in children and, to our knowledge, this is only the second reported case in a neonate. The patient was successfully managed by anticoagulation therapy followed by surgical excision of the tumour. This case illustrates the potentially fatal presentation of this benign cardiac tumour among neonates. Conclusion: Pulmonary haemorrhage of this degree is unusual in an otherwise healthy term neonate and needs careful investigation for unusual pathology including potential sources of pulmonary emboli in the heart. We emphasize the value of echocardiography in the evaluation of unexpected pulmonary haemorrhage in the newborn.- - - - - - - - - - ranking = 7keywords = haemorrhage (Clic here for more details about this article) |
8/30. Alveolar haemorrhage with pleural effusion as a manifestation of epithelioid haemangioendothelioma.A 22 year old male was admitted with haemoptysis. A chest X-ray showed bilateral confluent alveolar infiltrates. bronchoscopy revealed blood oozing from all bronchopulmonary segments. Open lung biopsy disclosed bilateral effusions and large necrotizing nodules with pleural adhesions. Histological examination showed tumour cells, which were negative to epithelial and embryogenic markers but positive to factor viii. This confirmed the diagnosis of an epithelioid haemangioendothelioma. This rare tumour, usually has an indolent course, whereas in our case it was complicated by alveolar and intrapleural bleeding.- - - - - - - - - - ranking = 4keywords = haemorrhage (Clic here for more details about this article) |
9/30. Acute idiopathic pulmonary haemorrhage in infancy: case report and review of the literature.This report presents the case of a 4-month-old male infant with recurrent bouts of haemoptysis for which no cause could be detected after extensive investigation. literature reports of this condition from other geographic locations around the world are reviewed, together with epidemiologic studies attempting to provide a link with certain environmental exposures, toxic and infectious. A diagnostic entity of acute idiopathic pulmonary haemorrhage in infancy has recently been proposed. To my knowledge, this is the first case reported from new zealand. Although the incidence of such reported cases appears to be rare, they constitute an interesting public health problem, particularly because some of the risk factors appear to overlap with risk factors for sudden infant death. They can therefore trigger an investigation into the home and outdoor environments, and may provide valuable insights into a possible underlying genetic factor and potentially harmful exposures in the modern urban or rural settings.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
10/30. Pulmonary arteriovenous malformation causing massive haemoptysis and complicated by coronary air embolism.We report the case of a 20-year-old man with possible Osler-Rendu-Weber syndrome (hereditary haemorrhagic telangiectasia) who developed an episode of massive haemoptysis from a bleeding pulmonary arteriovenous malformation in the left lower lobe of his lung. During the acute haemorrhage, he also appeared to suffer a coronary air embolism, possibly due to introduction of air into the bleeding arteriovenous malformation during intermittent positive pressure ventilation through the endotracheal tube. His electrocardiogram showed extensive ST elevation (>2 mm) in the inferolateral leads associated with raised troponin i and creatine kinase levels. These changes resolved within thirty minutes. The pulmonary arteriovenous malformation was successfully treated with a combination of alcohol injection and coil embolization.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
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