Fatal haemorrhage from Dieulafoy’s disease of the bronchus

• Published in: Thorax 1999-02, Vol.54 (2), p.184-185
• Main Authors: van der Werf, T S, Timmer, A, Zijlstra, J G
• Format: Article
• Language: English
• Subjects: Aged; Arteriovenous Malformations - complications; Arteriovenous Malformations - pathology; Biological and medical sciences; Biopsy; Bronchi - blood supply; bronchial vascular lesion; Bronchoscopy; Case Report; Chronic obstructive pulmonary disease; Dieulafoy’s disease; Embolization; fatal haemorrhage; Fatal Outcome; Female; Hemoptysis - etiology; Hemoptysis - pathology; Hemorrhage; Hemorrhage - etiology; Hemorrhage - pathology; Humans; Intensive care; Lung Diseases, Obstructive - complications; Medical sciences; Pneumology; Pneumonia; Pulmonary arteries; Pulmonary Artery - abnormalities; Pulmonary hypertension; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases; Recurrence; Respiratory failure; Respiratory Insufficiency - complications; Streptococcus infections; Tuberculosis; Veins & arteries
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thx.54.2.184

A 70 year old woman with a previous history of healed tuberculosis and suspected chronic obstructive pulmonary disease presented with recurrent haemoptysis and respiratory failure from a lobar pneumonia. Massive bleeding occurred when biopsy specimens were taken during bronchoscopy which was managed conservatively, but later there was a fatal rebleed from the same site. Two different Dieulafoy’s vascular malformations were found in the bronchial tree at necropsy, one of which was the biopsied lesion in the left upper lobe. This report confirms the possibility that vascular lesions occur in the bronchial tree. It is suggested that, if such lesions are suspected at bronchoscopy, bronchial and pulmonary arteriography with possible embolotherapy should be performed.