Massive Upper Airway Bleeding: A Rare Case of Aortobronchial Fistula

作者：Gudiel Arriaza Paola; Sanchez Serrano Amparo; do Vale Jorge Marques; Pereira Isabel Gil; Torres Antonio Simoes; Martin Sanchez Maria Jose

来源：Acta Medica Portuguesa, 2016, 29(6): 409-U69.

DOI：10.20344/amp.6842

• Aortic Diseases
• Bronchial Fistula
• Endovascular Procedures
• Hemoptysis

Clinical presentation of haemoptysis and haematemesis often generates confusion, becoming a difficult task to determine the source of upper airway bleeding. Aortobronchial fistula is a rare entity, but has been a reported complication in patients that have undergone aortic vascular surgery. A high clinical suspicion is fundamental to making this diagnosis. A 69 year old male, with a previous diagnosis of chronic gastritis, is admitted to the emergency room for vomiting blood. In the first 24 hours after admission, the patient develops respiratory insufficiency after an episode of massive bleeding from his mouth. A computed tomography is performed, which shows a descending thoracic aortic aneurism and signs of aortobronchial fistulae. Urgent thoracic endovascular repair was performed. Early symptoms of aortobronchial fistula are nonspecific which complicates the diagnosis and can lead to treatment delay. The use of bronchoscopy in these cases is controversial.

• 出版日期2016-6