Emergency surgery for massive haemoptysis

in Max Smart Super Speciality Hospital, Saket

Jan 06 , 2023

A 25-year-old woman with 28 weeks of pregnancy and no previous illness presented with massive haemoptysis to the emergency at Max Smart Super Speciality Hospital, Saket. She was admitted to the ICU and an MRI of the chest revealed bronchiectasis in the left upper lobe of the lung. She had massive bleeding in the ICU, necessitating intubation and ventilatory support.

She underwent Bronchial artery embolisation. Bronchoscopy revealed a few blood clots in the upper lobe of the left lung. The bleeding stopped, and she was weaned o from the ventilator. Two units of blood were transfused. She again had an episode of massive haemoptysis while in the ICU. She was intubated again. She was urgently taken up for surgery and a left upper lobectomy was performed.

The patient was shifted back to the ICU and was weaned o the ventilator the next day. She was shifted to a room after 48 hours of the surgery and was subsequently discharged. Her foetus was frequently evaluated by an obstetrician and was found to be normal.

Histopathology suggested tuberculosis, and anti-tubercular treatment was started. She later underwent elective Caesarean Section at 37 weeks of pregnancy and delivered a healthy baby.

Massive haemoptysis is a life-threatening condition and has a mortality rate of over 50%. Emergency lung lobectomy for life-threatening hemoptysis with successful outcomes is not reported in the literature.