CASE REPORT
A 60-year-old woman was admitted to the hospital due to right
periscapular dull pain, which worsened with changes in body position.
She also complained from shortness of breath, hoarseness, and dysphagia.
The patient had no known history of atherosclerosis, chronic or acute
lung disease, or thoracic trauma. A chest X-ray revealed the presence of
an expanded shadow at the right lung hilum with clearly defined oval
structures. Multispiral computed tomography (MSCT) (Figure 1) and
selective angiography of the right bronchial artery (Figure 2) were
performed, revealing 3 bronchial artery aneurysms (BAA) with cavities,
measuring 76mm, 25mm, and 22mm. Aneurysms were located in the posterior
right mediastinum under the tracheal bifurcation.
The patient was referred for surgery. A left-side thoracotomy was
performed along 4 intercostal spaces, after which the pulmonary
ligament, esophagus, left main bronchus, and tracheal bifurcation were
mobilized. Consequently, the descending aorta and its branches were
isolated and access to the contralateral pleural cavity was obtained. In
the posterior mediastinum, three aneurysms were found: one large
aneurysm measuring 7cm (Figure 3), and two smaller aneurysms measuring
1.5cm and 2cm, respectively. The feeding arteries were identified and
stapled, followed by excision of the aneurysms. The incision was closed
and drains were positioned. The patient was transferred to the intensive
care unit (ICU) with no complications.
Mechanical ventilation took 10 hours, and the patient could be
discharged from the ICU after 48 hours. After the drains had been
removed, the patient was transferred to the general ward. Postoperative
course was uneventful. According to post-operative control
echocardiography and MSCT, the patient showed no abnormalities and her
initial symptoms had been relieved. The patient was discharged 13 days
after surgery.