Abstract
BackgroundHemoptysis is a frequent sign of respiratory and non-respiratory diseases. While in most cases the underlying cause is rapidly identified, sometimes the real etiology might be misdiagnosed with dramatic delay in treatment.Case presentationA 46-year-old man with hiatal hernia and a history of aortic surgery for aortic coarctation presented with dramatic episodes of hemoptysis and subsequent severe anemia (6,9 g/dl). Digestive and respiratory endoscopy resulted not exhaustive, thus he underwent a contrast-enhanced computed tomography (CT) scan of the chest that showed an aneurysmal dilatation of the descending thoracic aorta with suspected aortobronchial fistula. He underwent cardiac surgery that confirmed the diagnosis and successfully treated the fistula.ConclusionWe briefly review the literature to raise clinical awareness on this uncommon cause of hemoptysis.
Highlights
Hemoptysis is a frequent sign of respiratory and non-respiratory diseases
A 46-year-old man with mild esophageal hiatal hernia and a history of cardiothoracic surgery for aortic coarctation presented with several dramatic episodes of hemoptysis with subsequent severe anemia due to aortobronchial fistula, probably a late consequence of the past aortic intervention
Case presentation A 46-year-old man with a recent diagnosis of hiatal hernia was admitted to the Respiratory Diseases Unit of the University Hospital of Modena, Italy for several dramatic episodes of hemoptysis during the previous 30 days, severe anemia (6,9 g/dl) and initial signs of hemodynamic instability
Summary
Hemoptysis is a frequent sign of respiratory and non-respiratory diseases. While in most cases the underlying cause is rapidly identified, sometimes the real etiology might be misdiagnosed with dramatic delay in treatment. Background A 46-year-old man with mild esophageal hiatal hernia and a history of cardiothoracic surgery for aortic coarctation presented with several dramatic episodes of hemoptysis with subsequent severe anemia due to aortobronchial fistula, probably a late consequence of the past aortic intervention. Despite being not very frequent as surgical case, aortobronchial fistula is not so rare as seems and it is most of the time a fatal complication.
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