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Park, Lee, Park, Son, Choi, Na, and Kwon: Successful Embolization in the Patient with Hemoptysis Due to Right Inferior Phrenic Artery-pulmonary Artery Anastomosis and Pseudoaneurysm
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 66(4): 319-323.

Published online: 30 April 2009

DOI: https://doi.org/10.4046/trd.2009.66.4.319

Successful Embolization in the Patient with Hemoptysis Due to Right Inferior Phrenic Artery-pulmonary Artery Anastomosis and Pseudoaneurysm

Hyun Woong Park, M.D.1, Go Eun Lee, M.D.1, Yong Sung Park, M.D.2, Ji Woong Son, M.D.1, Eu Gene Choi, M.D.1, Moon Jun Na, M.D.1, Sun Jung Kwon, M.D.1

1Division of Pulmonology, Konyang University College of Medicine, Daejon, Korea.

2Department of Diagnostic Radiology, Konyang University College of Medicine, Daejon, Korea.

Address for correspondence: Sun Jung Kwon, M.D. Department of Internal Medicine, Konyang University Hospital, 685, Kasuwon-dong, Seo-gu, Daejeon 302-718, Korea. Phone: 82-42-600-8820, Fax: 82-42-600-9090, sjoongkwon@hanmail.net

Received 2 April 2009       Accepted 22 April 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

The primary cause of hemoptysis is the bronchial artery. However, it should be noted that pulmonary artery and other vessels can cause hemoptysis. If the source of the bleeding is not determined after embolization, other evaluations are needed. Systemic-pulmonary anastomosis and pulmonary artery pseudo-aneurysm are rare vascular abnormalities with varying etiologies. An accurate and rapid diagnosis is needed in hemoptysis, since the cause may be life-threatening. We report a case of a 77-years-old man with persistent hemoptysis due to the right inferior phrenic artery - pulmonary artery anastomosis and pseudoaneurysm. After the embolization of the inferior phrenic artery, the hemoptysis was successfully treated.

Keywords: False Aneurysm, Hemoptysis, Embolization

Figures and Tables

Figure 1
(A) Initial chest X-ray at admission shows haziness in right lower lung. (B) Chest CT scan shows consolidation and ground glass opacity with 1.5 cm size, well marginated enhancing nodule in right lower lung.
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Figure 2
(A) Right bronchial angiogram, active bleeding (arrow) from branch of right lower bronchial artery are shown. (B) Bronchial artery embolization was done using the contour particle.
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Figure 3
(A) Inferior phrenic angiogram shows a pseudoaneurysm arising (arrow) from the right inferior phrenic artery shunting to right pulmonary artery. (B) After embolization with contour particle at distal part of right inferior phrenic artery, there was no more bleeding.
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Figure 4
Disappeared pseudoaneurysm of right lower lobe in chest CT scan at 10 days after embolization.
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