Intrapulmonary sequestration with destructive pneumonia and life-threatening hemoptysis in an adult patient: a case report
Jazyk angličtina Země Česko Médium print
Typ dokumentu kazuistiky, časopisecké články
PubMed
36809891
DOI
10.33699/pis.2023.102.1.23-27
PII: 133529
Knihovny.cz E-zdroje
- Klíčová slova
- Pneumonia, bronchopulmonary sequestration, hemoptea, hemoptysis, pneumonia,
- MeSH
- bronchopulmonální sekvestrace * komplikace diagnóza chirurgie MeSH
- dospělí MeSH
- hemoptýza diagnóza etiologie chirurgie MeSH
- krvácení MeSH
- lidé MeSH
- plíce chirurgie MeSH
- pneumonie * komplikace MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
The article reports the case of a patient with bronchopulmonary sequestration complicated by destructive actinomycotic inflammation leading to life-threatening hemoptysis. It was an adult patient with the history of repeated right-sided pneumonia the cause of which had not been investigated in detail in the past. Only hemoptysis, which appeared as a complication, led to a closer investigation of the background of repeated right-sided pneumonia. CT scan of the chest revealed a lesion of the middle lobe of the right lung with anomalous vascularization - compatible with intralobar sequestration. Initially, conservative antibiotic treatment of pneumonia was provided at a local clinic. Embolization of the afferent vessels of the sequestrum was indicated due to persistent hemoptysis; this led to a reduction of its blood supply, proven by a follow-up CT examination of the chest. Clinically, the hemoptysis subsided. Three weeks later, the hemoptysis reocurred. The patient was acutely hospitalized at a specialized thoracic surgery department where shortly after admission, hemoptysis progressed to life-threatening hemoptea. Urgent middle lobectomy of the right lung was approached via thoracotomy to treat the source of bleeding. The case describes unrecognized bronchopulmonary sequestration as a possible cause of recurrent ipsilateral pneumonia in adulthood; additionally, it emphasizes the possible risks associated with a pathologically altered tissue microenvironment of pulmonary sequestration, and the need for surgical removal in all indicated cases.
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