Hemomediastinum due to spontaneous rupture of a mediastinal bronchial artery aneurysm – A rare cause of thoracic pain

• Main Authors: B.A.H. Vosse, A.F. van Belle, G.J. de Vries, M. Das
• Format: Article
• Language: English
• Published: Elsevier 2014-01-01
• Series: Respiratory Medicine Case Reports
• Subjects: Bronchial artery aneurysm; Hemomediastinum; Thoracic pain; Superselective transcatheter embolization
• Online Access: http://www.sciencedirect.com/science/article/pii/S2213007114000173

Hemomediastinum is a rare pathological event. Multiple underlying causes and contributory factors can be identified, such as trauma, malignancy, iatrogenic, bleeding disorder or mediastinal organ hemorrhage. Also, a mediastinal bronchial artery aneurysm may be the source of a hemomediastinum. Hemoptysis is an important directive symptom, however occasionally, patients only present with thoracic pain or symptoms related to extrinsic compression of the airways or esophagus. Using contrast-enhanced computed tomography (CT) of the chest, hemomediastinum can be adequately diagnosed, and the involved vascular structures can be revealed. In case of a (ruptured) bronchial artery aneurysm, transcatheter embolization provides a minimally invasive procedure and is treatment of first choice. In this case report, a 76-year-old female is presented with spontaneous rupture of a mediastinal bronchial artery aneurysm resulting in hemomediastinum causing thoracic pain. Superselective embolization of the left bronchial artery was successfully performed.