title: A case of massive hemoptysis related to a smoking-history: an acquired form of the Dieulafoy's disease?
abstract: The hypervascularization of the bronquial wall, secondary to chronic bronchopulmonary inflammation is a bleeding etiology in smokers, but insufficient to explain certain massive recurrent cases. We report a case of a woman with a smoking history who presented a recurrent and massive hemoptysis. A diagnostic study with laboratory tests, bronchoscopy, computed tomography and echocardiogram did not identify the etiological cause. However, bronchial arteriography showed right and left bronchial tortuous and dilated arteries and demonstrated that a bronchovascular fistula was the origin of the hemoptysis. An acquired form of the Dieulafoy's disease in this context of a smoking history might justify such findings. Bronchial arteriography as a diagnostic method should be the preferred choice rather than bronchoscopy in these cases.
authors.affiliation: Intensive Care Unit, La Mancha Centro General Hospital, Alcázar de San Juan, Ciudad Real, Spain. Electronic address: apadilla@jccm.es.
authors.forename: A
authors.initials: A
authors.lastname: Padilla-Serrano
authors.affiliation: Intensive Care Unit, La Mancha Centro General Hospital, Alcázar de San Juan, Ciudad Real, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Estrella-Palomares
authors.affiliation: Intensive Care Unit, La Mancha Centro General Hospital, Alcázar de San Juan, Ciudad Real, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Martínez-Palacios
authors.affiliation: Department of Radiology, La Mancha Centro General Hospital, Alcázar de San Juan, Ciudad Real, Spain.
authors.forename: J
authors.initials: J
authors.lastname: González-Spínola
mesh_terms: D001158:Arteries / Q000002:abnormalities; D001980:Bronchi / Q000098:blood supply; D001983:Bronchial Fistula / Q000209:etiology*; D005260:Female; D006469:Hemoptysis / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D020545:Respiratory Mucosa / Q000098:blood supply; D012907:Smoking / Q000009:adverse effects*; D016157:Vascular Fistula / Q000209:etiology*
keywords: Bronchovascular fistula; Dieulafoy's disease; Hypervascularization; Massive hemoptysis; Smoking history; Vascular lesion