Abhishek Adhikari1, Shahjan Raj Giri1, Sudhir Yadav1, Roshan Gami2, Manoj Bist1 and Om Biju Panta1
1. Department of Radiology, Nepal Mediciti Hospital, Kathmandu, Nepal
2. Tribhuvan University Teaching hospital, Kathmandu, Nepal
Corresponding author: Abhishek Adhikari, abhishek09iom@gmail.com
Supervisor: Om Biju panta, bijupanta@yahoo.com
Consent:
Written informed consent was obtained from the patient to publish this report in accordance with the journal’s patient consent policy.
Abstract:
This case report describes a 41-year-old male patient whose screening chest X-ray revealed irregular tubular radio dense opacities in the right hilar region, suggestive of a vascular lesion. Subsequently, CT angiogram of the chest revealed a congenital bronchial artery-pulmonary artery fistula. Despite being informed about the diagnosis and available treatment options, the patient refused treatment and wanted to be on regular follow-up. This case highlights the importance of thorough imaging evaluation in diagnosing rare vascular abnormalities and explores the existing gap in literates regarding treatment in asymptomatic patients.
Key words
Bronchial-pulmonary artery, Arteriovenous malformation, CT angiography, Asymptomatic.
Introduction:
Abnormal communication between a systemic artery and pulmonary artery is a rare anomaly which may be congenital or acquired. The acquired causes of such malformations are inflammatory or infective lung disease, penetrating trauma, or tumor (2). Here we describe a primary anomalous communication between a dilated convoluted bronchial artery and the branch of the pulmonary artery incidentally found on a routine health checkup radiograph. Such communications have been given various names in the literature, one commonly used name being the racemose hemangioma of the bronchial artery (7).
Case Report.
A 41-year-old male patient came for a screening chest X-ray. He had no complaints. No history of fever, vomiting, and cough. No previous medical and surgical history was noted. Physical and clinical examination revealed no gross abnormalities. Chest X-ray PA view (Figure 1) demonstrated irregular tubular radiodense opacities on the right hilar region. Both lung fields were normal with normal broncho-vascular markings. A diagnosis of some form of vascular lesion was made and the patient was advised a CT angiogram chest.