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Hemoptysis after surgical repair of aortic thoracic dissection

Mercedes Suárez-Rodríguez, Virginia Leiro-Fernandez, María José Rodríguez Fernández, José Luis García-Tejedor, Francisco Javier Fernández, Javier de la Fuente Aguado

CaseRepClinPractRev 2004; 5:328-330

ID: 12341

Published: 2004-04-20

Background: Aortobronchial fistula is an uncommon disease. The main symptom is the hemoptysis that is a non-specific symptom. The habitual procedures used in its diagnosis are often unable to visualize
the source of bleeding.Thoracic angiography computed tomographic with tridimensional reconstruction can visualize thoracic structures and its relations, so may show direct or indirects signs of the bleeding etiology.Case Report: We present a case of hemoptysis in a 73-year-old man after surgical repair of aortic thoracic dissection 4 years before. A Dacron patch was used to repair the dissection zone. An angiography computed tomography with tridimensional reconstruction showed aortic dissection contacting a subsegmentary bronchi. These were direct signs of aortobronchial communication.Conclusions: A high index of clinical suspicion is necessary to early diagnosis of tracheobronchial fistula. It must be suspected in patients who have minor or major hemoptysis, with either coexisting thoracic aortic aneurysms or history of thoracic aneurysm repaired. Angiography computed tomographic should be considered in the initial investigation.

Keywords: aortobronchial fistulation, aortopulmonary fistula, aortic fistulation airways, Hemoptysis