title: An unusual cause of pulmonary artery pseudoaneurysm: acrylate embolism.
abstract: Sclerotherapy is commonly used to manage bleeding from oesophageal varices. In a patient with cirrhosis of the liver, sclerotherapy with bucrylate was followed by a pulmonary embolism and then by a decline in general health. A chest radiograph taken 5 months later disclosed a left perihilar opacity, surrounding and invading the pulmonary artery. Despite moderate fixation by positron emission tomography and inconclusive bronchoscopy findings, an upper left lobectomy was deemed in order. A left pulmonary artery pseudoaneurysm was found during the surgery. The pseudoaneurysm ruptured during dissection, requiring a left pneumonectomy. The pathological examination showed shredding of the left pulmonary artery, which contained foreign material. At points of contact with this material, destruction and severe polymorphic inflammation of the pulmonary parenchyma were noted. There was no evidence of tumour or infection. These findings strongly suggested an iatrogenic pulmonary artery pseudoaneurysm related to a bucrylate embolism through porto-systemic vascular shunts. We are not aware of previously reported cases.
authors.affiliation: Paris Descartes University, Paris,  France.
authors.forename: Giséle
authors.initials: G
authors.lastname: Mourin
authors.forename: Alain
authors.initials: A
authors.lastname: Badia
authors.forename: Aurélie
authors.initials: A
authors.lastname: Cazes
authors.forename: Benjamin
authors.initials: B
authors.lastname: Planquette
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001999:Bronchoscopy; D002015:Bucrylate / Q000009:adverse effects*; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D017809:Fatal Outcome; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D011013:Pneumonectomy / Q000009:adverse effects; D049268:Positron-Emission Tomography; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012597:Sclerosing Solutions / Q000009:adverse effects*; D015911:Sclerotherapy / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects
chemical_list: D012597:Sclerosing Solutions; D002015:Bucrylate