1. Intrapleural Rupture of a Pulmonary Arteriovenous Fistula Presenting with Hemothorax and Shock
- Author
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Hirotada Katsuya, Syoji Itoh, Masanao Miura, Junji Yamazaki, Eiitsu Baba, Yuri Aimi, and Nobuyoshi Kusama
- Subjects
medicine.medical_specialty ,Aortography ,medicine.diagnostic_test ,Pleural effusion ,business.industry ,medicine.medical_treatment ,medicine.disease ,Hemothorax ,Chest pain ,Pulmonary Arteriovenous Fistula ,Surgery ,Aortic aneurysm ,medicine.artery ,medicine ,Radiology ,Thoracotomy ,medicine.symptom ,Bronchial artery ,business - Abstract
We report a case of a ruptured pulmonary arteriovenous fistula (PAVF) which caused shock. A 72-year-old woman was transferred from a local hospital to our hospital because of sudden onset of left chest pain that followed hypotension and left pleural effusion. A suspended rupture of an aortic aneurysm was suggested, but results of transesophageal echocardiography and enhanced computed tomography provided no evidence of this diagnosis. Also, aortography performed on the 2nd hospital day, revealed no abnormalities of the intercostal and bronchial arteries, nor the source of the hemothorax. On the 3rd hospital day, she developed shock due to recurrent bleeding, therefore, probe thoracotomy was performed. Pulsative bleeding from the lung surface of the left S8 segment was observed and a diagnosis of a ruptured PAVF was confirmed. Left lower lobectomy was carried out and she was discharged on the 26th hospital day. There are few reports describing the intrapleural rupture of PAVF. This case suggests that pulmonary arteriography should be considered in addition to aortography in patients with sudden onset of chest pain and hemothorax.
- Published
- 2000
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