大動脈瘻による大量喀血を来した肺アスペルギルス症の1例

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  • A CASE OF PULMONARY ASPERGILLOMA SUPPOSED AN AORTIC FISTULA CAUSING MASSIVE HEMOPTYSIS

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The authors experienced a case of pulmonary aspergilloma an aortic fistula was supposed to cause massive hemoptysis.<br> A 75-year-old man who had been followed elsewhere for old tuberculosis and empyema of the left lung was referred to the hospital for the treatment of massive hemoptysis. The amount of bleeding increased rapidly after admission. It was considered that controlling the hemoptysis by medical treatment would be impossible and a left pneumonectomy was planned. At the time of operation, massive pulsatile bleeding suddenly occurred during the lung dissection. He went into acute shock. After immediate insertion of a baloon occlusion catheter into the aorta through the right femoral artery to control bleeding, the cavity of empyema was inspected. A defect of 1.0×1.5cm in diameter was found in the wall of the descending aorta. It was supposed that the fintula between the lung and aorta was the cause of massive hemoptysis. The pathological diagnosis was pulmonary aspergilloma.<br> Benign lung lesions complicated by hemoptysis often require surgical treatment. Although the fistula between the lung and aortic wall would be a rare complication, we surgeons should be aware of the possibility during the operation.

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