색전술로 치료한 폐동맥 가성동맥류 1예
A Case of Pulmonary Artery Pseudoaneurysm Treated by Embolization
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초록
폐동맥 가성동맥류는 패혈성 폐렴의 드문 합병증으로 발생할 수 있으며 대량객혈로 이어질 위험성이 높아 치명적일 수 있다. 대량객혈을 동반한 폐동맥 가성동맥류의 치료는 색전술 또는 수술이지만, 색전술 시행 후 폐동맥 가성동맥류의 경과는 보고된 적이 없었다. 저자는 59세 남자가 패혈성 폐렴에서 회복 중 대량객혈을 하여 흉부 전산화단층촬영을 시행하였고, 폐동맥 가성동맥류를 발견하여 폐동맥 색전술로 치료하였다. 이후 외래 추적도중 시행한 단순흉부촬영상에서 색전물질에 의한 방사선 비투과성 병변은 수개월에 걸쳐 서서히 작아졌다. 결국, 색전술 후 14개월째 시행한 흉부 전산화단층촬영에서 폐동맥 가성동맥류와 색전물질이 완전히 사라졌음을 관찰하였다.
Abstract
Pulmonary artery pseudoaneurysm (PAP) is a rare complication of septic pneumonia. It is potentially fatal because of the risk of massive hemoptysis. Treatment of PAP involving massive hemoptysis is by embolization or surgery. However, the progression of PAP after embolization has not been reported. A 59-year-old male who was recovering from septic pneumonia experienced massive hemoptysis. Computed tomography (CT) revealed PAP of the right pulmonary artery with surrounding consolidation, suggesting active hemorrhage. The patient was successfully treated with embolization of the right pulmonary artery. During outpatient follow-up, the amount of radiopaque embolized material gradually decreased on chest radiography. At 14 months after embolization, both the PAP and embolized material had disappeared on chest CT. (Korean J Med 2011;80:S214-S219)
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