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Emerg Med J. 2007 August; 24(8): 593.
PMCID: PMC2660098

Haemoptysis from the pulmonary artery

A 72‐year‐old woman presented because of cough with fresh blood for 3 days. She had a history of aortic dissection and underwent aortic arch reconstruction 12 years earlier. On arrival, her vital signs included blood pressure of 150/78 mm Hg and respiratory rate of 24 breathes/min. Physical examination revealed rales over the left hemithorax. Laboratory results included haemoglobin of 10.9 g/dl and platelet count of 113 000/μl. An oblique coronal reformatted image was performed by multislice computed tomography (MSCT) and demonstrated non‐tapering distal branches of the left pulmonary artery with an adjacent area of ground‐glass attenuation, indicating the culprit lesions (asterisk). The patient was treated conservatively and recovered uneventfully.

Most cases of haemoptysis (90%) originate from the bronchial circulation. MSCT angiography with a combination of multiplanar reformatted images can help identify the origins and courses of arteries that may be responsible for bleeding. Effective trans‐arterial embolisation requires such knowledge, particularly for differentiating pulmonary, bronchial or non‐bronchial systemic feeder vessels.1

figure em39172.f1
Figure 1 An oblique coronal maximum intensity projection reformatted image, obtained with 64 multislice computed tomography, demonstrating non‐tapering distal branches of the left pulmonary artery with an adjacent area of ground‐glass ...

References

1. Bruzzi J F, Remy‐Jardin M, Delhaye D. et al Multi‐detector row CT of haemoptysis. Radiographics 2006. 263–22.22 [PubMed]

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