Respir Case Rep. 2018; 7(2): 54-58 | DOI: 10.5505/respircase.2018.06978

Hemoptizi ile Baþvuran Yetiþkin Bir Hastada Sað Pulmoner Arter Proksimalinde Kesinti

Mustafa Belal Hafeez Chaudhry¹, Kumail Khandwala¹, Wasim Ahmed Memon¹, Taha Sheikh², Tanveer Ul Haq¹, Muhammad Arif Saeed^1
1Aga Khan Üniversitesi, Radyoloji Anabilim Dalý, Karachi, Pakistan
²Dow Saðlýk BilimleriÜniversitesi, týp Fakültesi, Karachi, Pakistan

Kýrk iki yaþýnda kadýn hasta, önceki günden beri 3 kez hemoptizi ataðý ve dispne yakýnmasý ile baþvurdu. Akciðer grafisinde sað akciðerde volüm kaybý ve hafif periferal fibrozis vardý. Yüksek rezolüsyonlu bilgisayarlý tomografide bu bulgulara ilave olarak sað pulmoner arterin olmadýðý belirlendi. Bu bilgi djijtal subtraction anjiografi ile doðrulandý ve sað akciðerin sadece sistemik dolaþýmdan beslendiði görüldü. Konvansiyonel angiografide herhangi bir ekstra damarlanma veya aktif kanama odaðý görülmedi. Pulmoner enfarkt riski nedeniyle ampirik embolizasyon yapýlmadý. Hasta semptomatik ve konservatif olarak tedavi edildi. Pulmoner arter anomalilerinin ayýrcý tanýsýnda bu durum önemli olup görüntüleme yöntemleri ile pulmoner damarsal obstrüksiyonlarýn nedenleri araþtýrýlmalýdýr.

Anahtar Kelimeler: pulmoner arter kesintisi, yüksek çözünürlüklü bilgisayarlý tomografi, dijital anjiografi

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Proximal Interruption of Right Pulmonary Artery in an Adult Patient Presenting with Hemoptysis

Mustafa Belal Hafeez Chaudhry¹, Kumail Khandwala¹, Wasim Ahmed Memon¹, Taha Sheikh², Tanveer Ul Haq¹, Muhammad Arif Saeed^1
1Department of Radiology, Aga Khan University, Karachi, Pakistan
²Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan

A 42 year old lady presented with dyspnea and 3 episodes of hemoptysis since 1 day. Her chest radiograph revealed mild peripheral fibrosis & volume loss in right lung, subsequent HRCT confirmed the findings with additional diagnosis of absence of the right main pulmonary artery. This was further confirmed on digital subtraction angiography and the right lung was solely supplied by the systemic circulation. The conventional angiography did not demonstrate any active extravasation or blush to suggest active bleeder. Empirical embolization was not attempted due to a risk of pulmonary infarction. Patient was managed symptomatically and conservatively.This condition is important to recognize in the list of differential diagnoses for pulmonary artery abnormalities and any acquired causes of pulmonary vasculature obstruction must be ruled out on imaging modalities.

Keywords: Proximal Interruption of Pulmonary Artery (PIPA), High Resolution Computed Tomography (HRCT), Digital Subtraction Angiography (DSA)

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