Intralobar sequestration presenting as a large intrapulmonary hematoma and massive hemothorax

Tamura, Yamato; Kushibe, Keiji; Terauchi, Takashi; Takahama, Makoto; Kimura, Michitaka; Taniguchi, Shigeki

doi:10.1007/s11748-006-0026-1

Cited by 5 publications

(3 citation statements)

References 7 publications

(6 reference statements)

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“…However, rare cases without a previous history of trauma have been reported, when the condition is referred to as spontaneous or idiopathic pulmonary hematoma. Anticoagulant therapy, thrombocytopenia, and rare diseases such as Ehlers-Danlos syndrome are some of the presumed causes of spontaneous or idiopathic pulmonary hematoma [1–7]. In our case, there was no history of trauma and no history of anticoagulant therapy, and his coagulation profile was normal.…”

Section: Discussionmentioning

confidence: 70%

“…Because pulmonary hematoma is visualized as an opacity on imaging examinations, it is often difficult to distinguish it from malignancy. However, pulmonary hematoma usually disappears spontaneously from 3 weeks to 3 months, in the absence of any special complications [7, 11]. Therefore, in the absence of any serious symptoms and the presence of sufficient evidence to suspect pulmonary hematoma, such as a previous history of trauma, the management would be conservative.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous pulmonary hematoma with diffuse pulmonary ossification requiring emergency treatment: a case report

et al. 2019

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Background Pulmonary hematoma is most often caused by thoracic trauma. However, rare cases of pulmonary hematoma without any obvious cause are sometimes reported, when the condition is referred to as spontaneous or idiopathic pulmonary hematoma. Herein, we report a very rare case—to the best of our knowledge, this is the first case of pulmonary hematoma associated with diffuse pulmonary ossification requiring emergency treatment reported in the English literature. Case presentation Our patient was a 44-year-old man with a history of IgA nephropathy and had no history of trauma or anticoagulant use. He presented with the chief complaint of bloody sputum and was referred to our hospital for detailed examination. Chest computed tomography showed a right pleural effusion and a large round mass in the right lower lobe. We performed chest tube drainage of the right thorax and confirmed bloody pleural effusion. Although bronchial artery embolization was performed, the patient’s anemia worsened, and we performed right lower lobectomy. Histopathological examination of the resected specimen showed a hematoma with diffuse pulmonary ossification, although the relationship between the two was unclear. There was no evidence of malignancy or angiitis. Therefore, we made the diagnosis of spontaneous pulmonary hematoma in this case. The postoperative course was uneventful. The patient is currently under observation as an outpatient, and a recent chest X-ray showed no evidence of recurrence. Conclusion We report a case of spontaneous pulmonary hematoma with diffuse pulmonary ossification. Although the relationship between the two remains unclear, considering the possibility of appearance of new lesions/recurrence, we believe that careful follow-up is necessary for this patient.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Spontaneous pulmonary hematoma with diffuse pulmonary ossification requiring emergency treatment: a case report

et al. 2019

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“…This might be due to the invasive effect of Aspergillus infection, or changes of state in blood vessel and blood flow caused by hypertension, aneurysm, salicylic acid drugs, and mechanical compression of the pectus excavatum. An additional excel file shows the details of these cases (see Supplementary Material 1) (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

Intralobar Pulmonary Sequestration Presenting as Hemothorax Secondary to Spontaneous Pneumothorax: Case Report and Literature Review

Chen

Zhang

et al. 2022

Front. Pediatr.

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IntroductionPatients with pulmonary sequestration (PS), a rare congenital lung malformation, are mostly asymptomatic. Recurrent localized infection is a major complication, while sudden hemothorax is extremely rare. We present a case of intralobar PS presenting as hemothorax secondary to spontaneous pneumothorax and comprehensively review the relevant literature.Case ReportA 16-year-old male presented with chest pain after strenuous exercise. Chest X-ray showed a moderate pneumothorax. After admission and conservative treatment, he developed dizziness, amaurosis, and urinary incontinence. Bedside chest X-ray suggested a massive pleural effusion, and hemothorax was further identified via catheter drainage. Contrast-enhanced computed tomography was performed, and no abnormal blood vessels or leakage of contrast agent were observed. As the hemoglobin level continued to drop, exploratory thoracoscopic surgery was performed immediately. The abnormal systemic artery supplying the lung tissue was found to be ruptured; therefore, ligation of the abnormal artery with resection of the diseased lung tissue was performed. Pathological examination revealed non-specific manifestations of PS. He was followed up for 1 year without related complications.ConclusionOur case suggests that the abnormal supply vessels of PS are unstable, which may cause sudden hemothorax. Therefore, patients with PS should undergo surgery promptly after diagnosis. In patients with hemothorax, we should consider the diagnosis of PS; however, contrast-enhanced computed tomography or angiography cannot confirm the diagnosis in all cases. Surgical intervention is recommended in emergency settings.

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A resected case of intralobar pulmonary sequestration showing rapid enlargement due to intrabronchial hemorrhage

Otsuka¹,

Hata²,

Sasamoto³

et al. 2010

The Journal of the Japanese Association for Chest Surgery

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Intralobar sequestration presenting as a large intrapulmonary hematoma and massive hemothorax

Cited by 5 publications

References 7 publications

Spontaneous pulmonary hematoma with diffuse pulmonary ossification requiring emergency treatment: a case report

Spontaneous pulmonary hematoma with diffuse pulmonary ossification requiring emergency treatment: a case report

Intralobar Pulmonary Sequestration Presenting as Hemothorax Secondary to Spontaneous Pneumothorax: Case Report and Literature Review

A resected case of intralobar pulmonary sequestration showing rapid enlargement due to intrabronchial hemorrhage

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