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Surgical management of pulmonary arteriovenous fistula in a female patient.

Ichiki Y, Kawasaki J, Hamatsu T, Suehiro T, Koike M, Tanaka F, Sugimachi K - Int J Surg Case Rep (2014)

Bottom Line: Based on these findings, a diagnosis of PAVF was confirmed.A PAVF is often associated with various complications, and pregnancy could be a risk factor for these complications because of the increase in the shunt fraction.Therefore, we thought that treatment should be recommended in this case in the event she might later choose to become pregnant.

View Article: PubMed Central - PubMed

Affiliation: Department of Chest Surgery, Onga Nakama Medical Association Onga Hospital, Onga-gun, Japan. Electronic address: y-ichiki@med.uoeh-u.ac.jp.

No MeSH data available.


Related in: MedlinePlus

(A) Chest X-rays showed abnormal shadows in the right upper and lower lung field. (B) Chest computed tomography revealed a 20 × 14 mm nodule with well-defined margins and smooth contours in the right upper lobe, and a 15 × 10 mm nodule with a similar form in the right lower lobe. (C) Contrast-enhanced three-dimensional CT revealed two enhanced lung nodules which were connected with linear structures suggestive of feeding arteries and drainage veins, respectively. (D) A right-to-left shunt fraction was 15.3% and abnormal uptake was detected in the brain and bilateral kidneys by lung perfusion scintigraphy.
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fig0005: (A) Chest X-rays showed abnormal shadows in the right upper and lower lung field. (B) Chest computed tomography revealed a 20 × 14 mm nodule with well-defined margins and smooth contours in the right upper lobe, and a 15 × 10 mm nodule with a similar form in the right lower lobe. (C) Contrast-enhanced three-dimensional CT revealed two enhanced lung nodules which were connected with linear structures suggestive of feeding arteries and drainage veins, respectively. (D) A right-to-left shunt fraction was 15.3% and abnormal uptake was detected in the brain and bilateral kidneys by lung perfusion scintigraphy.

Mentions: The patient was a 20-year-old asymptomatic female. During a physical examination, no cyanosis, clubbing of the fingers nor skin telangiectasia was detected. Her pulse oximetry oxygen saturation (SpO2) was 98% on room air. No significant murmur was audible in the right mammary area. Abnormal shadows in the right upper and lower lung fields were detected on chest X-rays (Fig. 1A). Chest computed tomography (CT) revealed a 20 × 14 mm nodule with well-defined margins and smooth contours in the right upper lobe, and a 15 × 10 mm nodule with a similar form in the right lower lobe (Fig. 1B). Contrast-enhanced 3D-CT revealed two enhanced lung nodules which were connected with linear structures suggestive of feeding arteries and drainage veins, respectively (Fig. 1C). Although an arterial blood gas analysis showed no hypoxemia, with an arterial oxygen pressure (PaO2) of 80 mm Hg on room air, the right-to-left shunt fraction was 15.3% and abnormal uptake was detected in the brain and bilateral kidneys by the lung perfusion scintigraphy (Fig. 1D). We thus made a preoperative diagnosis of PAVF. We performed partial pulmonary resection by VATS.


Surgical management of pulmonary arteriovenous fistula in a female patient.

Ichiki Y, Kawasaki J, Hamatsu T, Suehiro T, Koike M, Tanaka F, Sugimachi K - Int J Surg Case Rep (2014)

(A) Chest X-rays showed abnormal shadows in the right upper and lower lung field. (B) Chest computed tomography revealed a 20 × 14 mm nodule with well-defined margins and smooth contours in the right upper lobe, and a 15 × 10 mm nodule with a similar form in the right lower lobe. (C) Contrast-enhanced three-dimensional CT revealed two enhanced lung nodules which were connected with linear structures suggestive of feeding arteries and drainage veins, respectively. (D) A right-to-left shunt fraction was 15.3% and abnormal uptake was detected in the brain and bilateral kidneys by lung perfusion scintigraphy.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4336401&req=5

fig0005: (A) Chest X-rays showed abnormal shadows in the right upper and lower lung field. (B) Chest computed tomography revealed a 20 × 14 mm nodule with well-defined margins and smooth contours in the right upper lobe, and a 15 × 10 mm nodule with a similar form in the right lower lobe. (C) Contrast-enhanced three-dimensional CT revealed two enhanced lung nodules which were connected with linear structures suggestive of feeding arteries and drainage veins, respectively. (D) A right-to-left shunt fraction was 15.3% and abnormal uptake was detected in the brain and bilateral kidneys by lung perfusion scintigraphy.
Mentions: The patient was a 20-year-old asymptomatic female. During a physical examination, no cyanosis, clubbing of the fingers nor skin telangiectasia was detected. Her pulse oximetry oxygen saturation (SpO2) was 98% on room air. No significant murmur was audible in the right mammary area. Abnormal shadows in the right upper and lower lung fields were detected on chest X-rays (Fig. 1A). Chest computed tomography (CT) revealed a 20 × 14 mm nodule with well-defined margins and smooth contours in the right upper lobe, and a 15 × 10 mm nodule with a similar form in the right lower lobe (Fig. 1B). Contrast-enhanced 3D-CT revealed two enhanced lung nodules which were connected with linear structures suggestive of feeding arteries and drainage veins, respectively (Fig. 1C). Although an arterial blood gas analysis showed no hypoxemia, with an arterial oxygen pressure (PaO2) of 80 mm Hg on room air, the right-to-left shunt fraction was 15.3% and abnormal uptake was detected in the brain and bilateral kidneys by the lung perfusion scintigraphy (Fig. 1D). We thus made a preoperative diagnosis of PAVF. We performed partial pulmonary resection by VATS.

Bottom Line: Based on these findings, a diagnosis of PAVF was confirmed.A PAVF is often associated with various complications, and pregnancy could be a risk factor for these complications because of the increase in the shunt fraction.Therefore, we thought that treatment should be recommended in this case in the event she might later choose to become pregnant.

View Article: PubMed Central - PubMed

Affiliation: Department of Chest Surgery, Onga Nakama Medical Association Onga Hospital, Onga-gun, Japan. Electronic address: y-ichiki@med.uoeh-u.ac.jp.

No MeSH data available.


Related in: MedlinePlus