Treatment of Endobronchial Hemorrhage Using Balloon Tamponade and Bronchial Artery Embolization.

Kim, Min Keun; Kim, Ji Won; Baek, Sang Ah; Song, Jeong Eun; Park, Yon Woong; Kim, Kyung Chan

Case Report

Keimyung Medical Journal 2014;33(1):65-70.
Published online March 16, 2016.

Treatment of Endobronchial Hemorrhage Using Balloon Tamponade and Bronchial Artery Embolization.

Min Keun Kim, Ji Won Kim, Sang Ah Baek, Jeong Eun Song, Yon Woong Park, Kyung Chan Kim

Department of Internal Medicine, Catholic University of Daegu College of Medicine, Daegu, Korea. solar903@chol.com

Abstract

Endobronchial hemorrhage is common complication of bronchoscopic biopsy. There are several hemostatic methods including cold saline irrigation, topical vasoactive substance instillation, tranexamic acid treatment, and balloon tamponade. Insertion of balloon catheter into bronchoscopic working channel is relatively simple and useful method for the selective hemostasis. Here, we report a case of 75-year-old female patient who had hemorrhage during endobronchial biopsy with flexible bronchoscopy. Since primary treatments such as cold saline irrigation and epinephrine instillation had been failed to stop hemorrhage, balloon catheter was immediately inserted into the bleeding site for temporal hemostasis. And then, bronchial artery embolization was followed for the additional treatment of hemorrhage. We suggest to use balloon catheter as a bridge therapy before bronchial artery embolization.

Key Words: Balloon tamponade, Bronchial artery embolization, Bronchoscopy, Hemorrhage