BACKGROUND Bronchial Dieulafoy’s disease(BDD)is characterized by the erosion of an anomalous artery in the submucosa of the bronchus.The etiology of pediatric BDD is mainly congenital dysplasia of bronchus and pulmon...BACKGROUND Bronchial Dieulafoy’s disease(BDD)is characterized by the erosion of an anomalous artery in the submucosa of the bronchus.The etiology of pediatric BDD is mainly congenital dysplasia of bronchus and pulmonary arteries,which is different from chronic inflammatory injury of the airway in adult patients.The internal thoracic artery,subclavian artery,and intercostal artery are known to be involved in the blood supply to the BDD lesion in children.CASE SUMMARY We report a case of BDD in a 4-year-old boy with recurrent hemoptysis for one year.Selective angiography showed a dilated right bronchial artery,and anastomosis of its branches with the right lower pulmonary vascular network.Bronchoscopy showed nodular protrusion of the bronchial mucosa with a local scar.Selective embolization of the bronchial artery was performed to stop bleeding.One month after the first intervention,the symptoms of hemoptysis recurred.A computed tomography angiogram(CTA)showed another tortuous and dilated feeding artery in the right lower lung,which was an abnormal ascending branch of the inferior phrenic artery(IPA).The results of angiography were consistent with the CTA findings.The IPA was found to be another main supplying artery,which was not considered during the first intervention.Finally,the IPA was also treated by microsphere embolization combined with coil interventional closure.During the one-year follow-up,the patient never experienced hemoptysis.CONCLUSION The supplying arteries of the bleeding lesion in children with BDD may originate from multiple different aortopulmonary collateral arteries,and the IPA should be considered to reduce missed diagnosis.CTA is a noninvasive radiological examination for the screening of suspected vessels,which shows a high coincidence with angiography,and can serve as the first choice for the diagnosis of BDD.展开更多
Clinical characteristics of tuberculosis (TB) patients from southern China with pulmonary tuberculosis hemoptysis (PTH) were analyzed retrospectively in order to improve the diagnosis of TB, reduce mortality and preve...Clinical characteristics of tuberculosis (TB) patients from southern China with pulmonary tuberculosis hemoptysis (PTH) were analyzed retrospectively in order to improve the diagnosis of TB, reduce mortality and prevent the transmission of TB. A total of 1227 cases of pulmonary TB patients hospitalized in the Third Affiliated Hospital of Sun Yat-sen University and Guangzhou Chest Hospital from January to December of 2011 were analyzed retrospectively. 1) The male/female ratio of the 1227 tuberculosis cases was 2.15:1. There were 403 cases (32.8%) of PTH with a male/ female ratio of 3.03:1. 2) The ratio of patients with PTH to those with TB was designated as Rh. The Rh in the male group (36.2%, 303 cases) was higher than that in the female group (25.6%, 100 cases, risk ratio (RR) = 1.41, P ≤ 0.001). 3) The Rh in the elderly group (≥60 years old, 20.3%, 56 cases) was lower than that in the younger patients group (20 - 39 years old, 45.4%, 189 cases, RR = 2.51, P ≤ 0.001). 4) The Rh in initial treatment group (29.6%, 296 cases) was lower than that in the retreatment group (46.9%, 107 cases, RR = 1.58, P ≤ 0.001). 5) The Rh in sputum-positive TB patients (44.5%, 297 cases) was significantly higher than that in the smear-negative TB patients (18.9%, 106 cases, RR = 2.35, P ≤ 0.001). 6) The Rh of patients with lung lesions range 0.05). 7) The Rh of patients with cavities (51.8%, 309 cases) was higher than that of patients without cavities (14.9%, 94 cases, RR = 3.48, P ≤ 0.001). Male, young, retreated, sputum-positive TB patients and those with cavitary TB were more predisposed to PTH in southern China. TB patients with such characteristics should be sensitized and accorded good care.展开更多
基金the National Natural Science Foundation of China,No.81701888Science-Technology Support Plan Projects of Sichuan Province,No.2019YFS0239 and No.2023YFS0206.
文摘BACKGROUND Bronchial Dieulafoy’s disease(BDD)is characterized by the erosion of an anomalous artery in the submucosa of the bronchus.The etiology of pediatric BDD is mainly congenital dysplasia of bronchus and pulmonary arteries,which is different from chronic inflammatory injury of the airway in adult patients.The internal thoracic artery,subclavian artery,and intercostal artery are known to be involved in the blood supply to the BDD lesion in children.CASE SUMMARY We report a case of BDD in a 4-year-old boy with recurrent hemoptysis for one year.Selective angiography showed a dilated right bronchial artery,and anastomosis of its branches with the right lower pulmonary vascular network.Bronchoscopy showed nodular protrusion of the bronchial mucosa with a local scar.Selective embolization of the bronchial artery was performed to stop bleeding.One month after the first intervention,the symptoms of hemoptysis recurred.A computed tomography angiogram(CTA)showed another tortuous and dilated feeding artery in the right lower lung,which was an abnormal ascending branch of the inferior phrenic artery(IPA).The results of angiography were consistent with the CTA findings.The IPA was found to be another main supplying artery,which was not considered during the first intervention.Finally,the IPA was also treated by microsphere embolization combined with coil interventional closure.During the one-year follow-up,the patient never experienced hemoptysis.CONCLUSION The supplying arteries of the bleeding lesion in children with BDD may originate from multiple different aortopulmonary collateral arteries,and the IPA should be considered to reduce missed diagnosis.CTA is a noninvasive radiological examination for the screening of suspected vessels,which shows a high coincidence with angiography,and can serve as the first choice for the diagnosis of BDD.
文摘Clinical characteristics of tuberculosis (TB) patients from southern China with pulmonary tuberculosis hemoptysis (PTH) were analyzed retrospectively in order to improve the diagnosis of TB, reduce mortality and prevent the transmission of TB. A total of 1227 cases of pulmonary TB patients hospitalized in the Third Affiliated Hospital of Sun Yat-sen University and Guangzhou Chest Hospital from January to December of 2011 were analyzed retrospectively. 1) The male/female ratio of the 1227 tuberculosis cases was 2.15:1. There were 403 cases (32.8%) of PTH with a male/ female ratio of 3.03:1. 2) The ratio of patients with PTH to those with TB was designated as Rh. The Rh in the male group (36.2%, 303 cases) was higher than that in the female group (25.6%, 100 cases, risk ratio (RR) = 1.41, P ≤ 0.001). 3) The Rh in the elderly group (≥60 years old, 20.3%, 56 cases) was lower than that in the younger patients group (20 - 39 years old, 45.4%, 189 cases, RR = 2.51, P ≤ 0.001). 4) The Rh in initial treatment group (29.6%, 296 cases) was lower than that in the retreatment group (46.9%, 107 cases, RR = 1.58, P ≤ 0.001). 5) The Rh in sputum-positive TB patients (44.5%, 297 cases) was significantly higher than that in the smear-negative TB patients (18.9%, 106 cases, RR = 2.35, P ≤ 0.001). 6) The Rh of patients with lung lesions range 0.05). 7) The Rh of patients with cavities (51.8%, 309 cases) was higher than that of patients without cavities (14.9%, 94 cases, RR = 3.48, P ≤ 0.001). Male, young, retreated, sputum-positive TB patients and those with cavitary TB were more predisposed to PTH in southern China. TB patients with such characteristics should be sensitized and accorded good care.
