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Abstract

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Article in Japanese

Case Report

A case of intractable hemoptysis controlled by bronchial occlusion with an Endobronchial Watanabe Spigot (EWS)

Akiko Fujii1)  Yukihiro Misumi1)  Junichiro Hiyama2)  Hiromasa Koshizuka2)  Yosuke Miyakawa1)  Akihiro Hayashi3) 

1)Department of Pulmonary Medicine, Koga Hospital 21, Tenjin-kai 2)Department of Pulmonary Medicine 3)Department of Thoracic Surgery, Shin-Koga Hospital, Tenjin-kai

ABSTRACT

A man in his eighties with massive hemoptysis was referred to our hospital in order to control the bleeding. Chest computed tomography (CT) indicated that the hemoptysis originated from the right upper lobe. We performed arterial embolization twice, but failed to stop it. A surgical lobectomy was considered to be very difficult to perform because of his poor general condition and the strong adhesions between the right upper lobe and parietal pleura. We therefore performed fiberoptic bronchoscopy and plugged 4 EWS (Endobronchial Watanabe Spigot) into his right B1b, B1, B2, B3, and this procedure was able to successfully and completely control the hemoptysis. Bronchial occlusion with EWS has been developed in order to treat patients with intractable pneumothorax, pyothorax with bronchial fistula and similar problems. Our findings suggest that this method is also highly effective in controlling hemoptysis in cases in which arterial embolization is unable to stop the bleeding or surgery is difficult to perform.

KEYWORDS

Hemoptysis  Arterial embolization  Fiberoptic bronchoscopy  Bronchial occlusion  Endobronchial Watanabe Spigot (EWS) 

Received 平成19年10月1日

JJRS, 46(5): 416-419, 2008

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