• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.705-709
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• 2005

Background: To assess the outcome of pulmonary resection in the management of hemoptysis caused by benign inflammatory lung disease. Material and Method: A longitudinal cohort study of 45 consecutive patients who were presented with hemoptysis and were treated with pulmonary resection from January 1995 to May 2004. The predictive preoperative risk factors of morbidity and recurrence of hemoptysis were analyzed. The mean age of the patients was 47.1 years. The mean follow-up was $35\pm34$ months. Result: The overall hospital mortality rate was $4.4\%(2/45)$. Postoperative complications occurred in 8 patients $(18.6\%)$. Complications were more common in patients who received blood transfusion than non-transfused patients (p=0.002). Patients with tuberculous destroyed lung disease had more amount of preoperative hemoptysis (p=0.002), more probability of transfusion (p=0.001), more probability of undergoing pneumonectomy (p=0.039) and more probability of postoperative morbidity. Patients of undergoing pneumonectomy had more probability of reoperation due to postoperative bleeding (p=0.047). Hemoptysis recurred in five patients but three had been subsided and two sustained during follow-up. A latter two patients had been prescribed with antituberculosis medication due to relapse of tuberculosis. Conclusion: A tuberculous destroyed lung disease has a higher rate of postoperative morbidity than other inflammatory lung diseases. A pneumonectomy in patients of inflammatory lung disease should be performed with great caution especially because of postoperative bleeding. Future study with longer and larger follow-up might show the reasons of recurrence of hemoptysis.

• Journal of the Korean Society of Radiology
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• v.4 no.4
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• pp.17-24
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• 2010

Hemoptysis which is comparatively common symptom in respiratory disease patients is a clinical symptom which has high risk of death in spite of many curative means. Bronchial tube embolization is a very useful medical procedure when hemoptysis does not stop for treatment of internal medicine or surgery and in addition to the purpose of instant hemostasis, for patients for whom surgical operation is impossible or for the purpose of gaining time to improve the state of the patient before surgical operation. In relation to this, this study is to know of the usefulness of bronchial tube artery embolization. The objects were 60 persons for whom bronchial tube artery embolizations are conducted because of large hemoptysis occurred from March 2007 to December 2009 in J hospital. They had large hemoptysis of 400ml or more per day and 200ml or more at a time or though the quantity of hemoptysis was less than 400ml they did not respond to the treatment of internal medicine for 10 days or longer. The average age was 60.5 years and cause diseases were tuberculosis, bronchiectasis, and pneumonia and lung cancer. Embolus parts were Rt bronchial artery 19 examples, Lt bronchial artery, both bronchial artery, Rt Intercostobronchial artery, and they were the case where embolization for many blood vessels were simultaneously carried out. As embolus materials, PVA (conteour) and microcoil were used. In 76.6% of 60 persons of patients hemorrhage stopped with the lapse of time after the procedure and in 4 examples (6.6) re-embolization was carried out due to re-bleeding after the procedure. Bronchial tube artery embolization has high early success rate and effectively controls hemoptysis in the treatment of hemoptysis and is an effective emergency remedy for hemorrhage due to large hemoptysis and will be a good medical procedure which reduces death rate. In addition, primarily if it is conducted together with the treatment of internal medicine it will be, as an effective curative means for hemorrhage due to large hemoptysis, a good mediate radial rays medical procedure which reduces death rate.

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.50-57
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• 1995

Background: Transcather arterial embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function such as postpneumonectomy patients and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization and analysed the correlation of the clinical and angiographic characteristics and investigated the clinical course and outcome after arterial embolization in the patients with significant hemoptysis. Method: 58 patients with massive or recurrent hemoptysis underwent transcatheter arterial embolization for the treatment of hemoptysis from April 1992 to Sept. 1993. Results: Most common cause of hemoptysis was pulmonary tuberculosis(34 cases, 58.3%). Embolized vessels responsible for hemoptysis were 56 bronchial arteries and 32 nonbronchial systemic arteries. Initial most common angiographic findings were hypervascularity and shunt. Initial success rate of hemoptysis control revealed 81.1%. However, 15 of 58 patients(25.9%) showed recurrence of hemoptysis after transcatheter arterial embolization. The complications(18 cases, 31%) such as chest pain, fever, voiding difficulty, atelectasis, paralytic ileus and unwanted embolization were occured. Conclusion: Transcatheter arterial embolization is useful and relatively safe treatment modality for immediate bleeding control of patients with massive hemoptysis or inoperable cases. The further evaluation of the long term results according to the embolized material and underlying pulmonary disease will be required.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.629-638
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• 1997

Background : Surgical intervention is known as the principle management for hemoptysis of significant amount. But surgical procedure is applicable to only small number of patients because of increased mortality in emergency surgery and various functional and structural problems after lung resection. Bronchial artery embolization(BAE) has been used as an alternative interventional technique for immediate control of patients with increased risk for surgery due to recurrent or massive hemoptysis. BAE also has limitations such as recurrent bleeding after procedure and its role for the application to small amount of hemoptysis is still not established. Method : To evaluate immediate and long term effectiveness of BAE, we analysed 65 patients with hemoptysis according to therapeutic modalities they received ; BAE versus conservative management. Results : The success rate for immediate control of hemoptysis was significantly higher in BAE group with 43 cases(100%) among 43 cases compared with 17 cases(77%) among 22 cases in conservative group (p < 0.001). The disease control duration was $19.5{\pm}8.06$ months in BAE group and $18.8{\pm}6.06$ months in conservative group(p > 0.05). The therapeutic response in BAE group was 82%(36/43 cases) and 95%(21/22 cases) in conservative group (p > 0.05). According to the amount of hemoptysis, the therapeutic response were seen in 91%(29/32 cases) in less than 100ml and 85%(28/33 cases) in 100~400ml (p > 0.05). According to the manifestation of hemoptysis, the therapeutic response in groups of recurrent and nonrecurent were 87%(20/23 cases) and 88%(37/42 cases)(p > 0.05). Conclusion : The difference of therapeutic response between BAE and conservative group in patients with small amounts of hemoptysis was not found except for immediate control of hemoptysis.

• Tuberculosis and Respiratory Diseases
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• v.65 no.1
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• pp.29-33
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• 2008

Catamenial hemoptysis is a rare condition that's characterized by recurrent hemoptysis occurring in association with menstruation, and this is associated with the presence of intrapulmonary or endobronchial endometrial tissue. The diagnosis of pulmonary endometriosis can be made according to a typical clinical history and with exclusion of other causes of recurrent hemoptysis. Treatment of pulmonary endometriosis can be medical or surgical; however, the optimal management of this condition is still a matter of debate. Medical therapy may be problematic, due to recurrence of symptoms despite hormonal ablation, and adverse effects from long-term hormone therapy can also be a problem. We report here on a case of pulmonary endometriosis in a 23-year-old woman who presented with hemoptysis that occurred during the first 3 days of menstruation, and this happened over a 4 month period. She was successfully treated by video-assisted thoracoscopic surgery (VATS). No more hemoptysis was noted during 12 months of follow-up.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1097-1104
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• 1997

The expectoration of blood is always a fearful experience for the patient and a matter of grave concern to the attending physician, because it may be the warning sign of serious diseases. When such bleeding occurs, the possibility of its being due to pulmonary tuberculosis, bronchiectasis or carcinoma of the lung is promptly suggested. Nowadays, with the advance of modern diagnostic studies, differential diagnosis has become possible for the hemoptysis patients to have appropriate treatment. This evaluation is based on the review of 75 cases of patients whom we performed emergency open thoracotomies for 6 years from March 1992 to February 1997 in the Department of Thoracic and Cardiovascular Surgery, Seoul Adventist Hospital. The mean age of the patients was 36.6 years old with a range from 19 to 68, and most prevalent age group was thirties. The most common underlying lung disease causin hemoptysis was tuberculosis(44%). Most accurate diagnostic study was bronchoscopy during hemoptysis(95 Vo) and right middle & lower lobe(17.3%) was the most common site of lesion. Lobectomy(50%) was the most frequent operative method and recurrent hemoptysis(31.6%) was the most common postoperative complication. But most of the patients(82.6%) were completely recovered by surgical treatment. Now we concluded that the proper management of hemoptysis was completed by surgical approach with definite diagnosis and supportive medication.

• Journal of Chest Surgery
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• v.45 no.1
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• pp.49-52
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• 2012

A coronary-bronchial artery fistula is a very rare congenital anomaly of the coronary artery whose etiology and pathogenesis have not yet been clarified. Most patients with coronary-bronchial fistulas are asymptomatic; however, some patients present with congestive heart failure, infective endocarditis, myocardial ischemia induced by a coronary steal phenomenon, or rupture of an aneurysmal fistula. Furthermore, patients with a coronary-bronchial artery fistula rarely manifest life-threatening hemoptysis due to the associated bronchiectasis. We report herein the case of a patient with a coronary-bronchial artery fistula who had bronchiectasis and a history of massive hemoptysis and myocardial ischemia.

• Tuberculosis and Respiratory Diseases
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• v.65 no.3
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• pp.235-238
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• 2008

We treated a rare case of TO that presented with recurrent massive hemoptysis that resulted in total obstruction of the bronchus intermedius by very large blood clots. Bronchoscopic intervention resulted in a full recovery from the atelectasis. However, there are no guidelines for preventing recurrence of the hemoptysis or disease progression. Conservative and expectant management are used to treat these patients and most do well.

• Journal of Chest Surgery
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• v.34 no.7
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• pp.569-573
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• 2001

We experienced a case of hemoptysis caused by bilateral upper lobe aspergilloma. He was 66 years old and had a history of old unclear pulmonary tuberculosis with irregular medication 20 years ago and intermittent hemoptysis for several years. In x-ray study, there was a bilateral upper lobe aspergilloma with cavity. He received bilateral wedge resection through thoracotomy with some interval to reduce postoperative complications. We selected the priorty of operation through the bronchoscope in the operation room. Both sides had the same pathology of aspergilloma and he was discharged after an uneventful postoperative course.

• Journal of Chest Surgery
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• v.30 no.4
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• pp.423-427
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• 1997

Hemoptysis occurs quite frequently as a consequence of mitral stenosis, but massive, lirE threatening pulmonary hemorrhage is distinctly unusual. We report a 30 year old female who underwent cmcrgcncy rcdo double valve replacement for intractable pulmonary hemorrhage. she underwent mitral valve replacement (lonescu Shirley 27 mm) due to rheumatic valvular heart disease in 1984 and tricuspid valve annuloplasty (Carpentier's rlng 30mm) two years later She was admitted for massive hcmoptysis and dyspnea on the 26th of December, 1995. Medical treatment including transarterial embolization was given but was not satisfactory. Emergency valve replacement (Mitral valve , 51. Judc 29mm and tricuspid valve ; 51. Jude 33mm) was performed and hemoptysis was controlled dramatically 24 hours after surgery.