A Case of Cryptogenic Hemoptysis after General Anesthesia

全身麻醉後發生隱源性咳血之病例報告

丁曉嫻(Hsiao-Hsien Ting) ； 曾稼志(Chia-Chih Tseng) ； 黃儀鴻(Yi-Hung Huang) ； 吳國安(Kwok-On Ng) ； 黃維立(Wei-Li Huang) ； 江振豪(Chen-Hao Chiang)

《胸腔醫學》 31卷5期 (2016/10) Pp. 305-310

摘要

全身麻醉後發生咳血在病例報告中是常見的，大部分被認為和手術及麻醉相關，儘管經過完整的評估，仍有20-30% 是沒有明確的病因，被定義為隱源性咳血。手術期間發生隱源性咳血極少被報導，在此我們報告一位病例，在全身麻醉下順利完成頸椎手術後，開始出現間歇性咳出鮮血及血塊，經過胸腔X光、電腦斷層及支氣管鏡檢查，僅發現在左側小支氣管正在滲血。手術週期發生咳血原因及處置都在文中討論，而隱源性咳血的預後是很好的，但有復發咳血的可能，完整適當的咳血評估是很重要的，尤其是有潛在惡性腫瘤危險因子的病人。

關鍵字

隱源性咳血 ； 全身麻醉

並列摘要

Hemoptysis after general anesthesia is common, and is believed to be a consequence of surgical error or the anesthesia itself. Despite complete evaluation, 20-30% of cases of hemoptysis remain without an identified etiology and are considered cryptogenic hemoptysis. Perioperative cryptogenic hemoptysis has rarely been reported in the literature. Herein, we report the case of a patient who expectorated fresh blood intermittently, and a large blood clot after an uneventful cervical spine surgery under general anesthesia. Extensive evaluation including chest X-ray, computed tomography (CT), and bronchoscope identified active oozing from the left lingual segmental bronchus only. The differential diagnosis of perioperative hemoptysis and its management are discussed. The prognosis of cryptogenic hemoptysis is favorable, but hemoptysis may recur. Complete prompt evaluation is important, especially for patients with a risk of malignancy.

並列關鍵字

cryptogenic hemoptysis ； general anesthesia