28151860 Visualization

A 60 Age - year Age - old Age woman Sex patient was admitted Clinical_event to our hospital Nonbiological_location on Feb. Date 18, Date 2016 Date because of frequent Frequency episodes of hemoptysis Sign_symptom for 2 Duration weeks Duration .
In the previous Date decade Date , the patient had frequent Frequency but less Severity severe Severity episodes of hemoptysis History , which typically ensued following an upper Biological_structure respiratory Biological_structure tract Biological_structure infection Disease_disorder .
Ear, Diagnostic_procedure nose, Diagnostic_procedure and Diagnostic_procedure throat Diagnostic_procedure examination Diagnostic_procedure and laryngoscope Diagnostic_procedure failed to identify an apparent source Sign_symptom of Sign_symptom bleeding Sign_symptom .
CT Diagnostic_procedure chest Biological_structure scan revealed no abnormality Sign_symptom .
The most recent episode occurred after an upper Biological_structure respiratory Biological_structure tract Biological_structure infection Disease_disorder 2 Date weeks Date ago Date .
The patient coughed Sign_symptom up as much as about 500 Volume   mL Volume of fresh Sign_symptom blood Sign_symptom in an episode of hemoptysis Sign_symptom , which was alleviated by anti Medication - tussive Medication therapy Medication .
The patient denied History a History history History of History smoking History and History illicit History drug History use History .
Diagnostic Diagnostic_procedure workup Diagnostic_procedure revealed no evidence of coagulopathy Disease_disorder .
Upon admission Clinical_event , physical Diagnostic_procedure examination Diagnostic_procedure revealed signs of rhonchi Sign_symptom and reduced Lab_value breath Diagnostic_procedure sounds Diagnostic_procedure .
Bronchoscopy Diagnostic_procedure showed a 1 Distance - cm Distance lesion Sign_symptom at the membranous Biological_structure trachea Biological_structure 2 Distance   cm Distance to the carina Biological_structure .
Tortuous Sign_symptom blood Sign_symptom vessels Sign_symptom were observed running in the submucosa Biological_structure of Biological_structure the Biological_structure trachea Biological_structure (Fig.1).
CT Diagnostic_procedure angiography Diagnostic_procedure was performed, demonstrating an artery Sign_symptom extending Sign_symptom into the submucosa Biological_structure from the descending Biological_structure aorta Biological_structure (Fig.2).
A diagnosis of Dieulafoy Therapeutic_procedure disease Therapeutic_procedure of the trachea Biological_structure was entertained.
Since the blood Coreference vessel Coreference was considered to be the culprit of hemoptysis Sign_symptom , selective Detailed_description arterial Therapeutic_procedure embolization Therapeutic_procedure was performed 1 Date week Date later Date .
No fresh episode of acute Detailed_description hemoptysis Sign_symptom was observed and the patient was still being followed Clinical_event up Clinical_event at the Date time Date of Date writing Date this Date report Date .
This study was approved by Ethics Committee of Shanghai Jiao Tong University Affiliated Sixth People's Hospital, and also got an informed written consent from the patient.