Dieulafoy’s disease of the bronchial tree: a case report

ABSTRACT CONTEXT: Dieulafoy’s disease of the bronchial tree is a very rare condition. Few cases have been reported in the literature. It can be asymptomatic or manifest with massive hemoptysis. This disease should be considered among heavy smokers when recurrent massive hemoptysis is present amid otherwise normal findings. The treatment can be arterial embolization or surgical intervention. CASE REPORT: A 16-year-old girl was admitted to the emergency department due to hemoptysis with an unknown lesion in the bronchi. She had suffered massive hemoptysis and respiratory failure one week before admission. Fiberoptic bronchoscopy revealed a lesion in the bronchus of the right lower lobe, which was suspected to be a Dieulafoy lesion. Segmentectomy of the right lower lobe and excision of the lesion was carried out. The outcome for this patient was excellent. CONCLUSION: Dieulafoy’s disease is a rare vascular anomaly and it is extremely rare in the bronchial tree. In bronchial Dieulafoy’s disease, selective embolization has been suggested as a method for cessation of bleeding. Nevertheless, standard anatomical lung resection is a safe and curative alternative.

摘要背景：
支气管树迪厄拉富瓦病（Dieulafoy’s disease）是一种极为罕见的病症。目前文献中报道的病例极少。该病症可无明显症状，或以大咯血为临床表现。对于重度吸烟者，若出现反复大咯血且其他检查未见明显异常时，需将本病纳入鉴别诊断范围。其治疗方式可选择动脉栓塞术或外科手术干预。

病例报告：
一名16岁女性因咯血伴支气管不明病变急诊入院。患者于入院前一周曾出现大咯血及呼吸衰竭。纤维支气管镜检查显示右下叶支气管存在一处病变，疑似迪厄拉富瓦病变。遂行右下肺叶肺段切除术并切除病变组织。患者术后恢复良好。

结论：
迪厄拉富瓦病是一种罕见的血管畸形，在支气管树中发病尤为罕见。针对支气管迪厄拉富瓦病，有研究提出采用选择性栓塞术实现止血。但标准解剖性肺切除术仍是一种安全且可根治的替代方案。