A Case of Lung Aspergilloma in Which Endobronchial Watanabe Spigot (EWS) Was Not Effective for Hemoptysis

DOI 11 References
  • Machida Hisanori
    Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital
  • Shinohara Tsutomu
    Department of Clinical Investigation, National Hospital Organization National Kochi Hospital
  • Hatakeyama Nobuo
    Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital
  • Okano Yoshio
    Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital
  • Hino Hiroyuki
    Division of Respiratory Surgery, National Hospital Organization National Kochi Hospital
  • Ogushi Fumitaka
    Division of Pulmonary Medicine, National Hospital Organization National Kochi Hospital

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  • 喀血に対してendobronchial Watanabe spigot (EWS)による気管支充填術が有効でなかった肺アスペルギローマの1例

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Abstract

Background. Lung aspergilloma often causes of lung bleeding, which results from inflammation of the lungs. Generally bronchial artery embolization (BAE) is first tried for the treatment of massive hemorrhage due to lung aspergilloma, and if there were refractory to treatments, operation is considered. However, in some cases, these procedures are impossible because of poor physical condition or the treatment environment. Recently, cases in which endobronchial Watanabe spigots (EWS) have been attempted to be used to halt lung bleeding transbronchially are increasing. Case. A 62-year-old man was admitted on an urgent basis to our hospital for hemoptysis lasting for 2 months. He had an old scar with a cavity that derived from tuberculosis in his right upper chest, and this area was suspected to be the bleeding site. After admission, because his breathing problems were exacerbated, causing respiratory failure, we treated him using an artificial ventilator. Because bronchial artery embolism was difficult to perform, EWS was used for hemoptysis. Although temporary arrest of the hemorrhage was successful, complete hemoptysis was not possible. Conclusion. We propose that because blocking the bronchus with an EWS for hemoptysis is a comparative indication, we should change the procedure to BAE if it is not effective.

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