title: [Massive Upper Airway Bleeding: A Rare Case of Aortobronchial Fistula].
abstract: Clinical presentation of haemoptysis and haematemesis often generates confusion, becoming a difficult task to determine the source of upper airway bleeding. Aortobronchial fistula is a rare entity, but has been a reported complication in patients that have undergone aortic vascular surgery. A high clinical suspicion is fundamental to making this diagnosis. A 69 year old male, with a previous diagnosis of chronic gastritis, is admitted to the emergency room for vomiting blood. In the first 24 hours after admission, the patient develops respiratory insufficiency after an episode of massive bleeding from his mouth. A computed tomography is performed, which shows a descending thoracic aortic aneurism and signs of aortobronchial fistula. Urgent thoracic endovascular repair was performed. Early symptoms of aortobronchial fistulae are nonspecific which complicates the diagnosis and can lead to treatment delay. The use of bronchoscopy in these cases is controversial.
authors.affiliation: Departamento de Ciencias Biomédicas. Universidad de León.
authors.forename: Paola
authors.initials: P
authors.lastname: Gudiel Arriaza
authors.affiliation: Servicio de Neumología. Complejo Asistencial Universitario de Salamanca. Salamanca. Spain.
authors.forename: Amparo
authors.initials: A
authors.lastname: Sánchez Serrano
authors.affiliation: Serviço de Pneumologia. Centro Hospitalar Tondela-Viseu. Viseu. Portugal.
authors.forename: Jorge
authors.initials: J
authors.lastname: Marques do Vale
authors.affiliation: Serviço de Pneumologia. Centro Hospitalar Tondela-Viseu. Viseu. Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Gil Pereira
authors.affiliation: Serviço de Pneumologia. Centro Hospitalar Tondela-Viseu. Viseu. Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Simões Torres
authors.affiliation: Servicio de Radiodiagnóstico. Complejo Asistencial Universitario de Salamanca. Salamanca. Spain.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Martín Sánchez
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000150:complications*; D001983:Bronchial Fistula / Q000150:complications*; D006469:Hemoptysis / Q000209:etiology*; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D016157:Vascular Fistula / Q000150:complications*