Multidisciplinary Management of Lung Destruction Presenting with Massive Hemoptysis and Asphyxia

Abstract

Lung destruction with massive hemoptysis is a life-threatening condition associated with a poor prognosis in the absence of prompt management. Asphyxia due to the flooding of the airways rather than exsanguination is usually the cause of death, so the initial treatment is resuscitation and protecting the airway. Prompt identification of its causes and location is mandatory to do an adequate treatment and to avoid fatal complications. We describe the case of a patient who was an emergency admission with large volume hemoptysis and asphyxia. After lung destruction was confirmed the cause of massive hemoptysis by a chest computed tomography (CT)，She underwent bronchial artery embolization (BAE) and controlled the bleeding. But due to recurrent bleeding two days later, she performed pneumonectomy and achieved hemostasis. BAE is now considered as first-line therapy or may be used as a tool to stabilize the patient before surgery. Emergency pneumonectomy is indicated for lung destruction with recurrent hemoptysis not controlled by embolization and is generally considered a last resort.