Massive hemoptysis due to Rasmussen aneurysm: detection with helicoidal CT angiography and successful steel coil embolization.
OBJECTIVE
To present the successful management of two cases of massive hemoptysis related to pulmonary aneurysms in patients with active tuberculosis.


METHODS
Retrospective study in the respiratory intensive care unit (ICU) of a university hospital.


METHODS
Between July 1996 and January 2002, 46 cases of hemoptysis related to active tuberculosis needed ICU admission. In two cases, pulmonary aneurysm was the source of bleeding.


RESULTS
Diagnosis was suspected on enhanced CT scan and confirmed by pulmonary angiograms. Transcatheter occlusion of pulmonary arterial circulation was successful. Both patients were alive at 1-year follow-up.


CONCLUSIONS
Massive hemoptysis occurring in patients with active tuberculosis could arise from pulmonary aneurysms. In such cases, bronchial artery embolization is ineffective. Before referring those patients for emergency surgery, an alternative strategy using angiographic study and transcatheter occlusion of pulmonary arterial circulation might be of interest.
D000328:Adult; D000792:Angiography / Q000379:methods; D004621:Embolization, Therapeutic / Q000295:instrumentation; D006469:Hemoptysis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D013232:Steel; D014057:Tomography, X-Ray Computed
D013232:Steel