Life threatening hemoptysis and aberrant bronchial artery. A case report

Hemoptysis and pulmonary hemorrhage are rare pathological entities in childhood, however, both can be life threatening respiratory emergencies and can signify potentially serious underlying intrathoracic disease. We report an 11 year old female who had four episodes of hemoptysis (50 mL of bright red blood within 48 hours) without previous recurrent respiratory problems. The assessment by chest radiography, bronchoscopy and computed tomography (CT) was needed to diagnose the nature of the problem and to indicate the site and extent of the bleeding. The CT angiography of the thorax showed a right bronchial artery hypertrophy, abnormally originated from the aortic arch, next to an aberrant right subclavian artery. The bleeding was successfully controlled by right bronchial arterial embolization with 500-700 mu m polyvinyl alcohol (PVA) microspheres. The course was uncomplicated. The bronchial artery embolization is effective in controlling hemoptysis and complications are uncommon in the hand of an experienced operator. (C) 2010 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L. All rights reserved.