Massive hemoptysis is defined as pulmonary hemorrhage of more than 600ml to 800ml within 24hours. Among the many causes, the most common include pulmonary tuberculosis, abscess, bronchiectasis, cystic fibrosis bronchial carcinoma. Most acute
episodes of
hemoptysis last less than 24 hours and gradually subside. However, when the hemoptysis is massive, it carries a mortality rate of 50% to 100%. It is generally agreed that surgery is the treatment of choice for patients with massive hemoptysis.
We had the one case of 39 year-old male with recurrent massive hemoptysis. In the past history, he had pulmonary tuberculosis 20 years ago but no chest trauma. Previous chest CT showed well defined cavitary lesion with calcification of RUL. Under
the
bronchoscope finding, we indentified active bleeding from right upper lobe bronchus without endobronchial lesion. Therefore, emergency thoracotomy was done with impression of hemoptysis due to pulmonary tuberculosis. But operative findings were
as
follows; the 4th fractured rib was impacted into the lung parenchyme with severe adhesion and middle lobe was not inflated, So, Upper and middle lobectomy were performed. He was diagnosed finally by operative and pathological findings as massive
hemoptysis due to impaction of fractured rib into the lung parenchyme and discharged without complication.
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