The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
WCIM 2014 SEOUL KOREA 325
Poster Session
Figure 1.
Figure 3. Figure 4.
Figure 2.
Figure 1. CT findings was seen as 2.6cm size enhancing nodular lesion, suggesting pseudoaneurysm at Lt. subclavicular area with surrounding hematoma (arrow).
Figure 2. Sono guided thrombin injection was performed at pseudoaneurysm of Lt.
subclavian artery(A: pre-injection, B: post-injection).
Figure 3. A: Angiography was performed showed active bleeding some branch of Lt.
axillary artery (arrow). B: After embolization, angiography showed nonvisualization of extravasation of contrast media (arrow).
Figure 4. Post embolization CT fi ndings was showed no bleeding and decreased size of hematoma.
PS 1294 Pulmonology
A Case of Thrombotic Primary Venous Aneurysm of an Upper Extremity Causing Pulmonary Emboli after it was Squeezed
Min-Su Kim1, Sang Min Lee1 Gachon University Gil Hospital, Korea1
Venous aneurysms are rarely observed in the neck and upper extremities, and few symptoms other than aesthetic concerns arise. Recently, two case studies described patients with venous aneurysms involving the neck and upper extremities, respectively, which provoked venous thrombosis and subsequent pulmonary embolism. Here, we describe a patient who experienced sudden onset of chest pain and dyspnea after he squeezed a mass in his right upper arm, which was confi rmed to be venous aneurysm with thrombosis that caused a pulmonary embolism. A 27-year-old Korean male com- plained of chest pain and dyspnea that began after he had squeezed a mass on the medial side of his right upper arm. Computed tomography (CT) angiography and ve- nous Doppler ultrasonography revealed a right basilic vein aneurysm with an organized thrombosis causing pulmonary emboli. After 1 month of anticoagulation, the aneurysm was ligated and resected. During the operation, multiple venous aneurysms fi lled with organized thrombi were observed. This is the fi rst reported case of a thrombotic pri- mary venous aneurysm of an upper extremity causing pulmonary emboli after it was squeezed.
PS 1295 Pulmonology
Pulmonary Artery Aneurysm Disappeared by Antituber- culosis Agents
Young Min Rah1, Min Soo Han1, Kyoung Min Moon1, Sun Young Jung1, Yongseon Cho1
Eulji University School of Medicine, Korea1
Pulmonary artery aneurysm is known to be one of sequalaes by pulmonary tuberculo- sis and it occurs in up to 5% of the patients. Generally, in case of massive hemoptysis induced by pulmonary artery aneurysm, embolization or surgery is considered for treatment of choice. We report the case of pulmonary artery aneurysm disappeared by antituberculosis agents in a patient with a pulmonary tuberculosis admitted for hemoptysis. A 60-year-old man was admitted for cough and myalgia for 3 months.
Chest radiograph revealed multifocal patchy and cavitary lesions in left lung fi eld and right apical area (Fig. (a)). He was diagnosed with pulmonary tuberculosis by positive acid-fast bacilli and started antituberculosis agents (isoniazid, rifampicin, ethambutol, and pyrazinamide). Two weeks later, he was presented with hemoptysis about 300ml per day. A chest enhanced CT scan revealed a newly appeared about 1.7cm sized pul- monary artery aneurysm which was considered the cause of hemoptysis (Fig. (b)). We recommended pulmonary artery embolization to the patient for an effective treatment of hemoptysis, but he and his wife strongly refused the procedure. Thus, continuing antituberculosis agents, we closely observed the patient with conservative therapy such as administration of fl uids and tranexamic acid. Hemoptysis was gradually de- creased to scanty amount and eventually stopped. He was cured with 9 months course of antituberculosis drugs, and the pulmonary artery aneurysm was disappeared (Fig. (c)).
PS 1296 Pulmonology
Successfully Treated Huge Pulmonary Arteriovenous Malformation by Repeated Coil Embolization
Jimyung Park1,2, HyungJun Kim1,2, Jee min Kim1,2, Young Sik Park1,2
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National Uni- versity Hospital, Korea1, Department of Internal Medicine, Seoul National University College of Medicine, Korea2
Pulmonary arteriovenous malformation (AVM) is an abnormal vascular communication between pulmonary arteries and veins, bypassing the normal pulmonary capillary bed.
Pulmonary AVM results in right to left shunt, leading to hypoxemia, dyspnea, and cy- anosis. Clinical symptoms and signs of patients with pulmonary AVM vary depending on the size, number and fl ow of AVM. Transcatheter embolization is the treatment of choice for pulmonary AVM. Surgical resection is rarely necessary and used for patients who fail transcatheter embolization. Here we report a case of a 4cm sized huge pul- monary AVM which was successfully treated by repeated coil embolization without complication.
