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KMID : 0383820120720010068
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Tuberculosis and Respiratory Diseases
2012 Volume.72 No. 1 p.68 ~ p.71
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Treatment of Massive Hemoptysis Occurred from Destroyed Lung: Prevention of Contralateral Aspiration Using Endobronchial Blocker Followed by Pneumonectomy
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Kim Seul-Ki
Lee Eun-Jung
Park Ji-Young
Kim Eun-Young
Kang Kyung-Hwan
Chung Hoe-Hoon
Choi Cheon-Woong
Kim Yee-Hyung
Yoo Jee-Hong
Kwak Young-Tae
Cho Sang-Ho
Chung Jun-Young
Kim Dae-Hyun
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Abstract
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Untreated massive hemoptysis, especially in patients with tuberculous-destroyed lung, is a serious complication resulting in considerable morbidity and mortality. We report a case of a patient who had active tuberculosis and a destroyed left lung with massive bleeding. He was transferred to our clinic with intubation of a right-sided Robertshaw double lumen tube and right upper lobe collapse likely due to tube malposition that was presented on chest X-ray. Because hemoptysis had persisted after bronchial arterial embolizaton, we replaced the double lumen tube with a conventional endotracheal tube and inserted an endobronchial blocker into the left main bronchus through an endotracheal tube guided by bronchoscopy to prevent aspiration of blood into the right lung. Left pneumonectomy was performed and hemotpysis was ceased. We suggest that the use of an endobronchial blocker followed by surgery may be a safe and effective modality of treatment in patients with persistent bleeding after bronchial arterial embolization.
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KEYWORD
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Hemoptysis, Tuberculosis, Pneumonectomy
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