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British Journal of Anaesthesia, 2002, Vol. 88, No. 2 291-295
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Management of life-threatening haemoptysis

E. Håkanson*,1, I. E. Konstantinov2, S.-G. Fransson3 and R. Svedjeholm2

1Departments of Cardiothoracic Anaesthesia and Intensive Care, 2Cardiothoracic Surgery and 3Thoracic Radiology, Linköping Heart Center, University Hospital, SE-581 85 Linköping, Sweden*Corresponding author

Massive haemoptysis represents a major medical emergency that is associated with a high mortality. Here we present two cases of life-threatening haemoptysis, the first caused by rupture of an aortic aneurysm into the lung in a 37-yr-old woman with polyarteritis nodosa and the second caused by massive bleeding from an angiectatic vascular malformation in the right main bronchus in a 21-yr-old woman. Fibreoptic bronchoscopy played an essential role in the diagnostic process and management of the respiratory tract. Diagnosis in the first case was obtained by CT scan and the aneurysm was treated surgically. In the second case, bronchial arteriography contributed to both definitive diagnosis and treatment. Initial cardiorespiratory management, diagnostic procedures and definitive therapy are described and reviewed. Adequate early management of the cardiorespiratory system is essential to the outcome. Aggressive measures to elucidate the cause of haemoptysis and prompt therapy are warranted because of the high risk of recurrence.

Br J Anaesth 2002; 88: 291–5


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