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. 2022 Feb 17;9(2):003195.
doi: 10.12890/2022_003195. eCollection 2022.

Pseudoaneurysm of a Bronchial Artery: An Unusual Cause of Chest Pain

Pepijn Van Hove  1 , Thomas Jardinet  2
Affiliations

Pseudoaneurysm of a Bronchial Artery: An Unusual Cause of Chest Pain

Pepijn Van Hove et al. Eur J Case Rep Intern Med. .

Abstract

We report a case of a bronchial artery pseudoaneurysm presenting as acute retrosternal pain. We want to discuss and to announce the extremely rare finding of a bronchial artery pseudoaneurysm. Bronchial artery aneurysms and pseudoaneurysms are uncommon; however, missing this diagnosis is associated with significant morbidity and mortality. When suspecting this pathology urgent CT angiography and selective angiography (DSA) are crucial. Urgent treatment with transarterial embolization is preferred.

Learning points: Bronchial artery pseudoaneurysms are uncommon; however, missing this diagnosis is associated with significant morbidity and mortality.Haemoptysis and chest pain are the most common symptoms of bronchial artery pseudoaneurysms.Diagnosis is made with CT angiography and selective angiography (DSA). Transarterial embolization is the preferred type of treatment.

Keywords: Bronchial artery pseudoaneurysm; digital subtraction angiography; embolization; mediastinal haematoma.

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Conflict of interest statement

Conflicts of Interests: The authors declare there are no competing interests.

Figures

Figure 1
Figure 1
Computed tomography (CT) scan of the chest with IV contrast performed 36 hours after the acute event demonstrating haemorrhagic fluid in the mediastinum (black arrow) and the right pleural space (white arrow), and a small enhancing mass in the infracarinal space, representing the pseudoaneurysm (curved arrow)
Figure 2
Figure 2
Oblique maximum intensity projection (MIP) reconstruction demonstrates the origin of the pseudoaneurysm (black arrow) from a bronchial artery arising from the inferior aspect of the aortic arch (white arrow)
Figure 3
Figure 3
Selective angiography confirms the pseudoaneurysm (black arrow) arising from the bronchial artery (white arrow)
Figure 4
Figure 4
Similar MIP reconstruction of a CT scan performed 4 days before the acute event demonstrates the same bronchial artery (white arrow), with absence of any aneurysmal dilatation or any mediastinal haemorrhagic fluid
See this image and copyright information in PMC

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