Massive Hemoptysis due to Left Inferior Phrenic Artery-to-Left Pulmonary Artery Fistula in the Lingular Lobe of the Lung: A Case Report and Literature Review

左肺舌葉之左下橫膈動脈到左肺動脈廔管合併大量咳血：病例報告與文獻回顧

林靖傑(Ching-Chieh Lin) ； 黃才旺(Tsai-Wang Huang) ； 柯凱雄(Kai-Hsiung Ko) ； 彭萬誠(Wann-Cherng Perng) ； 簡志峯(Chih-Feng Giian) ； 陳盈潔(Ying-Chieh Chen)

《胸腔醫學》 33卷1期 (2018/02) Pp. 20-26

摘要

Massive hemoptysis is a pulmonary emergency requiring immediate management, such as bronchial angiographic embolization or surgical intervention. It occurs in various pulmonary diseases and typically derives from the bronchial arteries. We herein report a very rare case of a patient bleeding from a left inferior phrenic artery-to-pulmonary artery fistula, accompanied by focal bronchiectasis in the left lingular lobe of the lung. In this case, pulmonary angiography was useful for clarifying the etiology and the abnormal anastomosis. In cases of hemoptysis with an uncommon etiology, video-assisted thoracic surgery with surgical resection of the bleeding vessel is the definitive management.

關鍵字

bronchiectasis ； fistula ； hemoptysis ； non-bronchial artery

並列摘要

大量咳血是一種肺部急症，需要立即進行支氣管血管造影栓塞或外科手術。它發生於各種的肺部疾病，通常起源於支氣管動脈。我們的案例報告是一個71歲女性，曾有肺結核和支氣管擴張症的病史，最近1個月陸續有咳嗽症狀，入院前1天開始出現大量咳血，胸部電腦斷層發現左側肺部舌葉有異常的血管顯影合併支氣管擴張症。肺血管造影證實為一左下橫膈動脈到左肺動脈之廔管。最後，藉由胸腔內視鏡輔助手術切除異常部分的肺葉，並改善咳血的症狀。

並列關鍵字

支氣管擴張症 ； 廔管 ； 咳血 ； 非支氣管動脈