IMAGES IN THORAX
Massive pulmonary arteriovenous malformation presenting with tamponading haemothorax
1 Department of Thoracic Surgery, Guy’s Hospital, Kings College London, UK
2 Department of Interventional Radiology, Guy’s Hospital, Kings College London, UK
Correspondence to:
Correspondence to:
MrI Hunt
Department of Thoracic Surgery, Guy’s Hospital, Kings College London, St Thomas’ Road, London SE1 9RT, UK; ianjhunt@gmail.com
| The first 150 words of the full text of this article appear below. |
A 71-year-old woman presented with a 1-week history of dyspnoea, right pleuritic chest pain and bilateral ankle oedema. There was no history of cough, fever or haemoptysis. Her body mass index was >30. Her jugular venous pressure was raised with reduced air entry over the right lung base. She was anaemic (haemoglobin 6.8 g/dl, mean corpuscular volume 67) with type II respiratory failure (pH 7.40, oxygen tension 9.30 kPa, carbon dioxide tension 9.32 kPa on 0.5 fraction of inspired oxygen). Chest radiography revealed a moderate right pleural effusion. A chest drain was inserted in the emergency room and 2 litres of bloody effusion was drained. A subsequent contrast-enhanced CT scan of the chest revealed a probable pulmonary arteriovenous malformation (PAVM) in the right lower lobe and a compressing organised haemothorax with significant mediastinal shift (fig 1A
). Pulmonary angiography confirmed a massive PAVM with multiple large feeding arteries and other
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