title: Diagnosis and management of hemoptysis.
abstract: Hemoptysis is the expectoration of blood that originates from the lower respiratory tract. It is usually a self-limiting event but in fewer than 5% of cases it may be massive, representing a life-threatening condition that warrants urgent investigations and treatment. This article aims to provide a comprehensive literature review on hemoptysis, analyzing its causes and pathophysiologic mechanisms, and providing details about anatomy and imaging of systemic bronchial and nonbronchial arteries responsible for hemoptysis. Strengths and limits of chest radiography, bronchoscopy, multidetector computed tomography (MDCT), MDCT angiography and digital subtraction angiography to assess the cause and lead the treatment of hemoptysis were reported, with particular emphasis on MDCT angiography. Treatment options for recurrent or massive hemoptysis were summarized, highlighting the predominant role of bronchial artery embolization. Finally, a guide was proposed for managing massive and nonmassive hemoptysis, according to the most recent medical literature.
authors.affiliation: Department of Radiological Sciences, Gemelli Hospital, Catholic University, Rome, Italy. anna.larici@rm.unicatt.it.
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Larici
authors.forename: Paola
authors.initials: P
authors.lastname: Franchi
authors.forename: Mariaelena
authors.initials: M
authors.lastname: Occhipinti
authors.forename: Andrea
authors.initials: A
authors.lastname: Contegiacomo
authors.forename: Annemilia
authors.initials: A
authors.lastname: del Ciello
authors.forename: Lucio
authors.initials: L
authors.lastname: Calandriello
authors.forename: Maria Luigia
authors.initials: ML
authors.lastname: Storto
authors.forename: Riccardo
authors.initials: R
authors.lastname: Marano
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bonomo
mesh_terms: D015901:Angiography, Digital Subtraction; D001981:Bronchial Arteries / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic; D006469:Hemoptysis / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D061330:Multidetector Computed Tomography