폐동맥색전술로 치료된 Rasmussen 동맥류 1예

A Case of Rasmussen Aneurysm Treated by Pulmonary Arterial Embolization

  • 박성오 (울산대학교 의과대학 강릉병원 내과학교실) ;
  • 고혁 (울산대학교 의과대학 강릉병원 내과학교실) ;
  • 김수희 (울산대학교 의과대학 강릉병원 내과학교실) ;
  • 박완 (울산대학교 의과대학 강릉병원 내과학교실) ;
  • 이덕희 (울산대학교 의과대학 강릉병원 진단방사선과학교실) ;
  • 류대식 (울산대학교 의과대학 강릉병원 진단방사선과학교실) ;
  • 정복현 (울산대학교 의과대학 강릉병원 내과학교실)
  • Park, Sung-Oh (Department of Internal Medicine, Asan Kangnung Hospital, College of Medicine, University of Ulsan) ;
  • Ko, Hyuk (Department of Internal Medicine, Asan Kangnung Hospital, College of Medicine, University of Ulsan) ;
  • Kim, Su-Hee (Department of Internal Medicine, Asan Kangnung Hospital, College of Medicine, University of Ulsan) ;
  • Park, Wan (Department of Internal Medicine, Asan Kangnung Hospital, College of Medicine, University of Ulsan) ;
  • Lee, Deck-Hee (Department of Radiology, Asan Kangnung Hospital, College of Medicine, University of Ulsan) ;
  • Ryul, Dae-Sik (Department of Radiology, Asan Kangnung Hospital, College of Medicine, University of Ulsan) ;
  • Jung, Bock-Hyun (Department of Internal Medicine, Asan Kangnung Hospital, College of Medicine, University of Ulsan)
  • 발행 : 2001.07.30

초록

기관지 동맥 색전술에도 불구하고 반복되는 대량 객혈을 보이는 동공성 폐결핵 환자에서 나선형 CT를 이용하여 Rassmusen 동맥류의 위치 및 크기를 비교적 정확히 진단하여 coil 이용한 경도관 폐동맥 색전술로 성공적으로 지혈 시킨 사례를 경험하였기에 보고하는 바이다.

A 42 year-old male with a history of multidrug-resistant pulmonary tuberculosis suddenly developed massive hemoptysis. Embolization of a bronchial artery branch and the collateral systemic arteries did not resolve the recurrent bleeding. Spiral computerized tomography(spiral CT) of the chest showed contrast enhanced nodules within a large cavity at the left lower lobe in the arterial phase suggesting a Rasmussen aneurysm. A pulmonary angiogram showed abnormal vascular nodules at that site. Coils were deployed at both the proximal and distal vessels of this aneurysmal sac for embolization. Transcatheter arterial embolization is a safe and effective means of controlling bleeding from this pulmonary arterial pseudoaneurysm. Here we report a case of a Rasmussen aneurysm diagnosed by spiral CT, which was successfully treated by pulmonary arterial embolization with a coil.

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