Algorithm of diagnosis and surgical treatment of pulmonary hemorrhage

Abstract

Objective: Development and improvement of the algorithm of diagnosis and surgical treatment of pulmonary hemorrhages (PH).

Material and methods. The paper analyzes the results of surgical treatment of 47 patients with PH for the period from 2010 to 2013. Men - 29(61.7%), women - 22(46.8%). Five of the patients were previously conducted operations - hydatidectomy from lungs. Examination of patients with PH included CT - 12 and bronchoscopy - 32 patients. Diagnosed below diseases: erosive bronchitis - 6, bronchiectasis - 3, hydatid disease - 6, mass lesions - 9, pneumonia - 1, cystic disease - 3, specific tubercular process - 1, tromboembolism of small branches of the pulmonary artery - 1.

Results of treatment: in 30 cases performed primary hemostasis and treatment of the main disease, the remaining 17 patients underwent surgeries: in 7 cases hydatidectomy (41.1%), 4 - wedge resection of lung (23.5%), 3 - bilobektomy (17.6%), 1 - lobectomy (5.88%), 1 - extirpation of the mediastinal cyst (5.88%), 1 - transcatheter embolization of bronchial artery (5.88%). Postoperative complications occurred in 2 patients (11.7%), in one case - postoperative pneumonia, another noted festering of wound - complications eliminated conservatively. Hospital mortality is not registered.

CONCLUSIONS: All patients to confirm the diagnosis is recommended to perform bronchoscopy, which can also serve as a therapeutic tool to stop bleeding from small vessels. At the height of PH, in the presence of conditions for angiography contrast aortography needed to identify possible sources of bleeding. When organic lesions of the lung tissue in patients previously performed operations, and recurrent bleeding it is indicated resection interventions.