Pulmonary arteriovenous fistula as a complication of trauma

Posttraumatic Pulmonary Arteriovenous Fistula: Is Resection the Procedure of Choice? A Case Report and Review of Literature

“…Two thirds of reported cases have presented or been diagnosed in a delayed fashion after the original insult (1-35 years). 1,2,[5][6][7][8][9][10][11][12][13][14] Delay in presentation can be attributed to the rarity of the lesion, slow recanalization of organized hematoma, eventual rupture of a traumatic pseudoaneurysm into a pulmonary vein, or slow erosion from a retained foreign body. 1,5,9 Recurrent bleeding into the chest in our patient suggests that the diagnosis of pulmonary arterial/venous injury was missed during the initial thoracotomy.…”

“…2 The rare nature of these lesions is attributed to the relatively low blood pressure within the pulmonary artery and the low pressure differential between the pulmonary artery and vein. 2,9,11,12 Two thirds of reported cases were the result of either a gunshot wound or shrapnel injury and the remainder of cases were the result of stab wounds. 1,2,[5][6][7][8][9][10][11][12][13][14] Therapeutic options include open direct repair through an arteriotomy or venotomy, lung resection to include the lesion, and balloon or coil embolization.…”

“…2,9,11,12 Two thirds of reported cases were the result of either a gunshot wound or shrapnel injury and the remainder of cases were the result of stab wounds. 1,2,[5][6][7][8][9][10][11][12][13][14] Therapeutic options include open direct repair through an arteriotomy or venotomy, lung resection to include the lesion, and balloon or coil embolization. 1,2,[5][6][7][8][9][10][11][12][13][14] Of the 12 cases reviewed, 3 patients underwent open repair of their PAVFs.…”

“…1,2,[5][6][7][8][9][10][11][12][13][14] Therapeutic options include open direct repair through an arteriotomy or venotomy, lung resection to include the lesion, and balloon or coil embolization. 1,2,[5][6][7][8][9][10][11][12][13][14] Of the 12 cases reviewed, 3 patients underwent open repair of their PAVFs. 1,2,[5][6][7][8][9][10][11][12][13][14] Of the patients treated with open repair, one died as a result of gram-negative sepsis and the other two were alive at discharge.…”

“…1,2,[5][6][7][8][9][10][11][12][13][14] Of the 12 cases reviewed, 3 patients underwent open repair of their PAVFs. 1,2,[5][6][7][8][9][10][11][12][13][14] Of the patients treated with open repair, one died as a result of gram-negative sepsis and the other two were alive at discharge. 5,10,14 Five patients underwent lung resection to include the lesion and all were alive at discharge.…”