A novel endobronchial approach to massive hemoptysis complicating silicone Y-stent placement for tracheobronchomalacia: A case report.

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

Medicine

authors

Ryu C,Boffa D,Bramley K,Pisani M,Puchalski J

doi

10.1097/MD.0000000000009980

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

e9980

issue

8

eissn

0025-7974

issn

1536-5964

pii

00005792-201802230-00065

journal_volume

97

pub_type

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