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Two cases of Dieulafoy lesions of the bronchus with novel comorbid associations and endobronchial ablative management.

Abstract Dieulafoy lesions are aberrantly large submucosal arteries most frequently associated with gastrointestinal hemorrhage. They are rarely identified in the bronchial submucosa and can cause massive hemoptysis.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29465555
OWN - NLM
STAT- MEDLINE
DCOM- 20180302
LR  - 20180302
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 8
DP  - 2018 Feb
TI  - Two cases of Dieulafoy lesions of the bronchus with novel comorbid associations
      and endobronchial ablative management.
PG  - e9754
LID - 10.1097/MD.0000000000009754 [doi]
AB  - RATIONALE: Dieulafoy lesions are aberrantly large submucosal arteries most
      frequently associated with gastrointestinal hemorrhage. They are rarely
      identified in the bronchial submucosa and can cause massive hemoptysis. PATIENT
      CONCERNS: We present three episodes of massive hemoptysis in two patients, the
      first with comorbid Alagille syndrome including multiple cardiac and pulmonary
      vascular abnormalities and the second with thyroid cancer metastatic to the
      mediastinum. DIAGNOSES: All episodes were due to Dieulafoy lesions of the
      bronchus based on bronchoscopic appearance. INTERVENTIONS: Bronchoscopic ablation
      using Nd:YAP laser was attempted both patients. OUTCOMES: Nd:YAP laser
      successfully ablated the Dieulafoy lesion in the first case with long-term relief
      from recurrent hemoptysis. The first episode in the second patient responded to
      bronchial artery embolization; laser ablation of a different Dieulafoy lesion
      responsible for the second episode was unsuccessful but additional bronchial
      artery embolization has provided relief from further episodes. LESSONS:
      Bronchoscopic ablation of Dieulafoy lesions of the bronchus can provide durable
      relief from recurrent symptoms. Clinical and anatomical features should be
      considered carefully before intervention, which should only be attempted by
      experienced operators with appropriate ancillary support available.
FAU - Sheth, Hardik S
AU  - Sheth HS
AD  - D. Y. Patil University School of Medicine, Mumbai, India.
FAU - Maldonado, Fabien
AU  - Maldonado F
AD  - Division of Allergy, Pulmonary, and Critical Care Medicine.
AD  - Department of Thoracic Surgery, Vanderbilt University School of Medicine,
      Nashville, TN, USA.
FAU - Lentz, Robert J
AU  - Lentz RJ
AD  - Division of Allergy, Pulmonary, and Critical Care Medicine.
AD  - Department of Thoracic Surgery, Vanderbilt University School of Medicine,
      Nashville, TN, USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Ablation Techniques/*methods
MH  - Aged
MH  - Alagille Syndrome/pathology
MH  - Bronchi/blood supply/surgery
MH  - Bronchial Diseases/complications/*surgery
MH  - Bronchoscopy/*methods
MH  - Comorbidity
MH  - Female
MH  - Hemoptysis/etiology/*surgery
MH  - Humans
MH  - Male
MH  - Mediastinal Neoplasms/secondary
MH  - Middle Aged
MH  - Thyroid Neoplasms/pathology
MH  - Vascular Malformations/complications/*surgery
EDAT- 2018/02/22 06:00
MHDA- 2018/03/03 06:00
CRDT- 2018/02/22 06:00
PHST- 2018/02/22 06:00 [entrez]
PHST- 2018/02/22 06:00 [pubmed]
PHST- 2018/03/03 06:00 [medline]
AID - 10.1097/MD.0000000000009754 [doi]
AID - 00005792-201802230-00020 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Feb;97(8):e9754. doi: 10.1097/MD.0000000000009754.