Airway management of ruptured pulmonary artery "Rasmussen" aneurysm and massive hemoptysis

Abstract

Abstract Background: Pulmonary tuberculosis is caused by Mycobacterium tuberculosis and its manifestations may include parenchymal, airway, vascular, pleural, mediastinal and chest wall lesions. Hemoptysis is a common complication of the disease. Massive hemoptysis occurs in about 8 % of cases; with associated mortality ranging from 5 to 25 % Massive hemoptysis secondary to pulmonary artery aneurysm rupture is a rare phenomenon presenting unique challenges in airway management and stabilization of oxygenation, ventilation and blood pressure. Case history: We present a case of a patient with necrotizing pulmonary tuberculosis complicated by a ruptured pulmonary artery "Rasmussen" aneurysm requiring emergent intubation and embolization. Conclusion: Massive hemoptysis should be treated as a medical emergency requiring the coordinated care of multiple specialists including intensivists, interventional radiologists, anesthesiologists, and surgeons. Airway management and stabilization of cardiorespiratory status should be the highest priority, followed by timely diagnostic procedures to localize the site and cause of the bleeding.