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Treatment of Massive Hemoptysis Occurred from Destroyed Lung: Prevention of Contralateral Aspiration Using Endobronchial Blocker Followed by Pneumonectomy

파괴폐에서 발생한 대량객혈의 치료: Endobronchial Blocker를 이용하여 반대측 폐로의 흡인을 방지한 후 시행한 전폐절제술

  • Kim, Seul-Ki (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Lee, Eun-Jung (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Park, Ji-Young (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Kim, Eun-Young (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Kang, Kyung-Hwan (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Chung, Hoe-Hoon (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Choi, Cheon-Woong (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Kim, Yee-Hyung (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Yoo, Jee-Hong (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Kwak, Young-Tae (Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Gangdong) ;
  • Cho, Sang-Ho (Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Gangdong) ;
  • Chung, Jun-Young (Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Kim, Dae-Hyun (Department of Thoracic and Cardiovascular Surgery, Kyung Hee University Hospital at Gangdong)
  • 김슬기 (강동경희대학교병원 호흡기내과) ;
  • 이은정 (강동경희대학교병원 호흡기내과) ;
  • 박지영 (강동경희대학교병원 호흡기내과) ;
  • 김은영 (강동경희대학교병원 호흡기내과) ;
  • 강경환 (강동경희대학교병원 호흡기내과) ;
  • 정회훈 (강동경희대학교병원 호흡기내과) ;
  • 최천웅 (강동경희대학교병원 호흡기내과) ;
  • 김이형 (강동경희대학교병원 호흡기내과) ;
  • 유지홍 (강동경희대학교병원 호흡기내과) ;
  • 곽영태 (강동경희대학교병원 흉부외과) ;
  • 조상호 (강동경희대학교병원 흉부외과) ;
  • 정준영 (강동경희대학교병원 마취과) ;
  • 김대현 (강동경희대학교병원 흉부외과)
  • Received : 2011.08.02
  • Accepted : 2011.10.07
  • Published : 2012.01.30

Abstract

Untreated massive hemoptysis, especially in patients with tuberculous-destroyed lung, is a serious complication resulting in considerable morbidity and mortality. We report a case of a patient who had active tuberculosis and a destroyed left lung with massive bleeding. He was transferred to our clinic with intubation of a right-sided Robertshaw double lumen tube and right upper lobe collapse likely due to tube malposition that was presented on chest X-ray. Because hemoptysis had persisted after bronchial arterial embolizaton, we replaced the double lumen tube with a conventional endotracheal tube and inserted an endobronchial blocker into the left main bronchus through an endotracheal tube guided by bronchoscopy to prevent aspiration of blood into the right lung. Left pneumonectomy was performed and hemotpysis was ceased. We suggest that the use of an endobronchial blocker followed by surgery may be a safe and effective modality of treatment in patients with persistent bleeding after bronchial arterial embolization.

Keywords

References

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