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Images in Thorax
Rare cause of massive haemoptysis diagnosed by ultrasonography in the ICU
  1. Wincy Wing Sze Ng1,
  2. Kevin Chin2,
  3. Sin Man Lam1
  1. 1Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong
  2. 2Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong
  1. Correspondence to Dr Wincy Wing Sze Ng, Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong; wincyngwingsze{at}gmail.com

http://dx.doi.org/10.1136/thorax-2022-219559

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    Description

    A 65-year-old man, who was a never smoker and enjoyed unremarkable past health, presented to the emergency department due to massive haemoptysis. The patient suffered from a brief pulseless electrical activity arrest of 4 min soon after arrival. The patient was then transferred to the intensive care unit after emergency endotracheal intubation. Contrast-enhanced CT (CECT) of the thorax showed consolidation within dependent areas of the right upper and lower lobes, compatible with aspiration of blood products (figure 1A). Cavitation and chronic lung changes were absent (figure 1B). There was no bronchial artery dilatation or hypertrophy on CT angiogram. Fibreoptic bronchoscopy performed via the endotracheal tube could not identify any endobronchial lesions. Bronchoscopic aspirates sent for microbiological evaluation were negative. Evaluation of the upper airway by an otorhinolaryngologist was unrevealing.

    Figure 1

    (A) Axial contrast-enhanced CT (CECT) of the thorax showed dependent patchy consolidation and ground glass change (white arrow) in right upper lobe of lung, in keeping with clinical history of massive haemoptysis. (B) A selected image of CECT of the thorax reformatted in coronal plane. There …

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    Footnotes

    • Contributors WW-SN was the lead author involved in drafting the initial manuscript and preparing the images. KC provided radiological expertise including interpretation and description of the images. All authors contributed to the writing, review and final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.