Tuberc Respir Dis > Volume 72(1); 2012 > Article
Tuberculosis and Respiratory Diseases 2012;72(1):68-71.
DOI: https://doi.org/10.4046/trd.2012.72.1.68    Published online January 1, 2012.
Treatment of Massive Hemoptysis Occurred from Destroyed Lung: Prevention of Contralateral Aspiration Using Endobronchial Blocker Followed by Pneumonectomy.
Seulki Kim, Eun Jung Lee, Ji Young Park, Eun Young Kim, Kyung Hwan Kang, Hoe Hoon Chung, Cheon Woong Choi, Yee Hyung Kim, Jee Hong Yoo, Young Tae Kwak, Sang Ho Cho, Jun Young Chung, Dae Hyun Kim
1Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
2Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea. kmctskdh@hanmail.net
3Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
Abstract
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.
Key Words: Hemoptysis, Tuberculosis, Pneumonectomy
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