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Eur J Cardiothorac Surg 2007;32:679-681. doi:10.1016/j.ejcts.2007.06.035
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Case reports

Delayed massive hemoptysis 20 years after lung stabbing: an unusual presentation

Mohsen Sokouti*, Vahid Montazeri

Department of Thoracic Surgery, Imam Khomeini Hospital, Tabriz University of Medical Sciences, Tabriz, Iran

Received 14 April 2007; received in revised form 23 June 2007; accepted 26 June 2007.

* Corresponding author. Tel.: +411 3347054 57; fax: +411 3366634. (Email: sokouti_m{at}yahoo.com).

The management of penetrating chest injury by bullet or shrapnel for prevention of later complications has remained controversial. A 45-year-old man presented with a history of 3 years recurrent hemoptysis. He had massive hemoptysis 20 h before admission. He underwent tube thoracostomy for the left hemothorax due to a penetrating chest injury that occurred 20 years previously during the Iran–Iraq war. Since then he had only vague pain in the left side of thorax without any respiratory sign. Chest radiography and computerized tomography revealed a 60 mm x 30 mm x 20 mm abnormal density in the hilum of the left lung near the main pulmonary artery. The hemoptysis was controlled by an emergency resection of the lower segment of left upper lobe and lingulae lobectomy. A large metallic foreign body was extracted. Pathology of the resected specimen revealed a metallic foreign body with chronic pneumonia of the lingulae lobe. This rare case reveals the important clinical fact that a penetrating chest trauma can present as massive life-threatening hemoptysis 20 years later.

Key Words: Shrapnel injury • Lung • Delayed hemoptysis • Massive






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Copyright © 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.