Misdiagnosis of pulmonary artery aneurysm with eroding thrombus into the airways. A fatal case of suffocation
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Misdiagnosis of pulmonary artery aneurysm with eroding thrombus into the airways. A fatal case of suffocation. / Svendsen, Ida Marie; Rasmussen, Marina; Henningsen, Maria Høy; Banner, Jytte.
I: Scandinavian Journal of Forensic Science, Bind 27, Nr. 1, 2021, s. 1-4.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Misdiagnosis of pulmonary artery aneurysm with eroding thrombus into the airways. A fatal case of suffocation
AU - Svendsen, Ida Marie
AU - Rasmussen, Marina
AU - Henningsen, Maria Høy
AU - Banner, Jytte
PY - 2021
Y1 - 2021
N2 - We present a fatal case of hemoptysis following a thrombus-eroding pulmonary artery aneurysm into the left upper bronchus of a 79-year-old male with a history of multiple hospital contacts and examinations due to cough, hemoptysis, and reflux symptoms.A postmortem computed tomography (CT) scan revealed a hyperdense, condensed area in the left lung in relation to the lung hilus. At autopsy, the forensic specialist discovered a large, organized thrombus in a pulmonary artery aneurysm. The thrombus was adherent to the pulmonary artery aneurysm wall with an underlying defect directly communicating to the left upper bronchus. The cause of death was asphyxia due to blood in the airways (i.e., suffocation).The combination of pulmonary artery hypertension, previous pulmonary embolism, and hemoptysis should lead to a particularly thorough inspection of the lungs with a focus on the pulmonary circulation. This case report emphasizes the importance of early detection of patients at risk of pulmonary artery rupture and attentiveness when performing biopsies during bronchoscopy to prevent communication between the artery and the airway. The risk of rupturing an aneurysm should be taken into account when performing biopsies on excrescence intruding into the bronchus in patients with medical histories of pulmonary hypertension, cough, and sporadic hemoptysis.
AB - We present a fatal case of hemoptysis following a thrombus-eroding pulmonary artery aneurysm into the left upper bronchus of a 79-year-old male with a history of multiple hospital contacts and examinations due to cough, hemoptysis, and reflux symptoms.A postmortem computed tomography (CT) scan revealed a hyperdense, condensed area in the left lung in relation to the lung hilus. At autopsy, the forensic specialist discovered a large, organized thrombus in a pulmonary artery aneurysm. The thrombus was adherent to the pulmonary artery aneurysm wall with an underlying defect directly communicating to the left upper bronchus. The cause of death was asphyxia due to blood in the airways (i.e., suffocation).The combination of pulmonary artery hypertension, previous pulmonary embolism, and hemoptysis should lead to a particularly thorough inspection of the lungs with a focus on the pulmonary circulation. This case report emphasizes the importance of early detection of patients at risk of pulmonary artery rupture and attentiveness when performing biopsies during bronchoscopy to prevent communication between the artery and the airway. The risk of rupturing an aneurysm should be taken into account when performing biopsies on excrescence intruding into the bronchus in patients with medical histories of pulmonary hypertension, cough, and sporadic hemoptysis.
KW - Hemoptysis
KW - pulmonary artery aneurysm
KW - aneurysm rupture
KW - autopsy
KW - case report
U2 - 10.2478/sjfs-2021-0001
DO - 10.2478/sjfs-2021-0001
M3 - Journal article
VL - 27
SP - 1
EP - 4
JO - Scandinavian Journal of Forensic Science
JF - Scandinavian Journal of Forensic Science
SN - 1503-9552
IS - 1
ER -
ID: 291532024