CTICasesPost-Thromboendarterectomy Pulmonary Hemorrhage
Imaging findings
Chest radiograph and CT of a patient post-pulmonary thromboendarterectomy on extracorporeal membrane oxygenation show diffuse, dense, complete opacification of both lungs. Every single airway, including the trachea and major bronchi up to the level of the endotracheal tube, is completely filled with fluid of soft-tissue or blood attenuation, with no air bronchograms visible, following massive, uncontrolled airway hemorrhage. A bronchial blocker is positioned in the left main bronchus.
Key takeaways
Massive pulmonary airway hemorrhage is a rare but catastrophic potential complication of pulmonary thromboendarterectomy. In extreme cases of uncontrollable bleeding, clinical teams may employ measures such as placing bronchial blockers or even clamping the endotracheal tube while the patient is supported on extracorporeal membrane oxygenation in an attempt to tamponade the hemorrhage.
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