Acute Hemoptysis and Pulmonary Hemorrhage after Judo as Presentation of Intralobar Sequestration

Abstract

Intralobar sequestration (ILS) is a rare anomaly that is usually diagnosed with symptoms of cough, expectoration, or recurrent pneumonia in children. We experienced a case of an 11-year-old boy with massive hemoptysis after judo sports. He was admitted to hospital and intubated due to respiratory failure. His chest computed tomography (CT) scan which was performed without contrast agent revealed a large intrapulmonary hematoma or tumor, mimicking traumatic hemothorax. Due to blood loss and circulatory instability, emergency thoracotomy was performed and a massive intralobar hemorrhage due to a ruptured ILS artery was found. After lobectomy including resection of the ILS, the patient was stabilized and extubated. Aspergillus was detected in the resected lobe and postoperatively acute respiratory distress syndrome (ARDS) and invasive aspergillosis occurred and was treated specifically. However, the young patient was discharged home 3 weeks later. In young patients with hemoptysis and intrapulmonary hemorrhage after trauma, the possibility of ruptured ILS should be kept in mind. This report shows that ILS can have a dramatic course of disease, and for this reason a nonurgent resection should be considered in all patients when this diagnosis is made.

Enfermedad de riesgo vital de origen respiratorio o alérgico en el deporte

“…Una historia de neumotórax espontáneo 37,38 , ciertos defectos congénitos pulmonares 39,40 , infecciones de las vías respiratorias bajas 41,42 , la limitación crónica del flujo aéreo 43 , la sensibilización previa a ciertos alimentos, a picaduras de insectos y el asma, en concreto 44 , serán las afectaciones más comunes y que deberemos tener muy en cuenta. En el ámbito de la neumología la mayoría de las enfermedades observadas producen una dificultad respiratoria al ejercicio que en la práctica nunca pondrá en riesgo la vida del paciente, dado que la intensidad del ejercicio está limitada por la propia enfermedad respiratoria; también es cierto que sí existen enfermedades que por sus caracterís-ticas deben tenerse en cuenta, sobre todo si además del estrés físico hay un estrés ambiental al que se somete al organismo 45,46 .…”

Pulmonary sequestration with Aspergillus infection presenting as massive hemoptysis and hemothorax with highly elevated carcinoembryonic antigen in pleural effusion that mimics advanced lung malignancy

“…It can be defined as a part of the lung that has no normal communication with the bronchial tree and receives blood supply from systemic arteries [1]. In recent decades, there have been several reports of PS associated with massive hemoptysis, hemothorax, and elevated tumor markers such as carcinoembryonic antigen (CEA) or even diagnosed with lung malignancy [2][3][4]. These clinical features combined with lung lesions on chest imaging are hard to differentiate from lung malignancies and often complicate the diagnostic procedure [5,6].…”

Pulmonary Sequestration With Fungus Infection Presenting as Highly Elevated Carcinoembryonic Antigen

“…It can be de ned as a part of the lung that has no normal communication with the bronchial tree and receives its blood supply instead from the systemic arteries (1). In recent decades, there have been several reports of PS associated with massive hemoptysis, hemothorax, and elevated tumor markers such as carcinoembryonic antigen (CEA) or even diagnosed with lung malignancy (2)(3)(4).…”