Case 58

 A fifty two-year-old male came to our hospital for hemosputum each time coughing for the past couple of days. The volume of hemosputum was two large spoons. He was once diagnosed pulmonary emphysema in a local clinic. He experienced gastro-duodenal ulcer in the past. Laboratory test revealed no abnormality except activated partial thromboplastin time (APTT) of 38.9 seconds (24 -35) and cholinesterase of 435 (185-431). He consented to take chest non-enhanced CT (Fig. 1). He was prescribed coagulant agent for a few days. Three days after, he visited us again for continuous hemosputum, bloody smell in the oral cavity and slight chest pain. He consented to have contrast-enhanced CT (Fig. 2). The respiratory physician recommended him to receive bronchial arterial embolization (BAE) because of continuous hemosputum despite oral coagulants. He was convinced to undergo BAE.

What is the appropriate management for hemosputum in this case ?

1. Embolization with gelatin sponge particles

2. Embolization with n-butyl cyanoacrylate

3. Embolization with microcoils

4. Embolization with polyvinyl alcohol

5. Embolization with ethanol + lipiodol

answer

2017.6.14