Tuberc Respir Dis.  2012 Jan;72(1):68-71.

Treatment of Massive Hemoptysis Occurred from Destroyed Lung: Prevention of Contralateral Aspiration Using Endobronchial Blocker Followed by Pneumonectomy

• Kim S
• Lee EJ
• Park JY
• Kim EY
• Kang KH
• Chung HH
• Choi CW
• Kim YH
• Yoo JH
• Kwak YT
• Cho SH
• Chung JY
• Kim DH

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.

Keyword

Hemoptysis; Tuberculosis; Pneumonectomy

MeSH Terms

Bronchi
Bronchoscopy
Hemoptysis
Hemorrhage
Humans
Intubation
Lung
Pneumonectomy
Thorax
Tuberculosis

Figure

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  Figure 1 The initial chest CT showed total parenchymal destruction of the left destroyed lung and total collapse of the right upper lobe of lung. CT: computed tomography.

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  Figure 2 Chest X-ray after endotracheal tube replacement and insertion of the endobronchial blocker.

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  Figure 3 Chest X-ray studied 12 days after left pneumonectomy.

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  Figure 4 The endobronchial blocker.

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