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Thorax doi:10.1136/thoraxjnl-2012-202869
  • Chest clinic
  • Images in thorax

Life-threatening haemoptysis due to tracheal varices secondary to pulmonary vein obstruction

  1. Stewart Craig1
  1. 1Cardiothoracic Surgery Department, NHS National Waiting Times Centre Board, Golden Jubilee National Hospital, Clydebank, Glasgow, UK
  2. 2Radiology Department, Glasgow Royal Infirmary, Glasgow, UK
  1. Correspondence to Karim Hani Kamel Morcos, Cardiothoracic Surgery Department, NHS National Waiting Times Centre Board, Golden Jubilee National Hospital, Agamemnon Street, Clydebank, Glasgow G81 4DY, UK; karimkamel7{at}gmail.com
  • Received 14 October 2012
  • Revised 15 November 2012
  • Accepted 31 December 2012
  • Published Online First 24 January 2013

History

A 30-year-old man with a 3 day history of increasing breathlessness and frank haemoptysis was suspected of having pulmonary embolism and anticoagulated with heparin. Haemoptysis worsened so anticoagulation was reversed and he was transferred to our institution.

Pulmonary and bronchial angiography revealed a small right pulmonary artery and a prominent right intercostobronchial trunk which was embolised. However, haemoptysis recurred and a contrast enhanced ECG-gated CT scan confirmed a hypoplastic right pulmonary artery and showed thrombosed right pulmonary veins that had no communication to the left atrium, a ‘bulky’ right hilum and thickened bronchial walls with smooth mucosal indentations into the …

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