Abstract:
RATIONALE:Airway stabilization for severe, symptomatic tracheobronchomalacia (TBM) may be accomplished by silicone Y-stent placement. Common complications of the Y-stent include mucus plugging and granulation tissue formation. PATIENT CONCERNS:We describe a rare case of massive hemoptysis originating from a silicone Y-stent placed for TBM. DIAGNOSES:An emergent bronchoscopy showed an actively bleeding, pulsatile vessel at the distal end of the left bronchial limb of the Y-stent. It was felt that the bleeding was caused by, or at least impacted by, the distal left bronchial limb of the Y-stent eroding into the airway wall. INTERVENTIONS:We hypothesized that placement of oxidized regenerated cellulose (ORC) would provide initial hemostasis, and the subsequent placement of a biocompatible surgical sealant would lead to definitive resolution. OUTCOMES:ORC provided sufficient hemostasis and the subsequent synthetic polymer reinforced the tissue for complete cessation of the bleed. LESSONS:The combined use of ORC and a biocompatible surgical sealant provided long-term management for life-threatening hemoptysis, and potentially morbid procedures such as embolization or surgery were avoided by advanced endobronchial therapy.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Ryu C,Boffa D,Bramley K,Pisani M,Puchalski Jdoi
10.1097/MD.0000000000009980subject
Has Abstractpub_date
2018-02-01 00:00:00pages
e9980issue
8eissn
0025-7974issn
1536-5964pii
00005792-201802230-00065journal_volume
97pub_type
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