2019 Volume 33 Issue 6 Pages 641-646
"Pulmonary aspergillosis" is a collective term used to refer to conditions caused by infection with a fungus of Aspergillus species. Individuals with pulmonary aspergillosis undergo antifungal therapy. Surgical treatment (e.g., bronchial artery embolization (BAE) ) can be considered in patients suffering from pulmonary aspergillosis if control of hemoptysis is very poor. The indication (s) for surgical treatment must be considered very carefully, but emergency surgery is indicated in the event of sudden, massive hemoptysis. We describe four patients who underwent emergency surgery due to massive hemoptysis. Two of the four were complicated by allergic bronchopulmonary aspergillosis (ABPA) and one with nontuberculous mycobacteriosis (NTM). BAE was carried out for hemoptysis, but control of the latter was not possible in any of the four patients. A left upper lobectomy was performed for one patient with pulmonary aspergilloma alone, a left residual pneumonectomy and left lower lobectomy in each of the patients with ABPA, and a left pneumonectomy in the patient with NTM. Hemoptysis was controlled in all patients. However, the patient with NTM died due to complications, and the other three patients survived. These data suggest that surgical therapy can be a rescue procedure for patients with massive hemoptysis that cannot be controlled by BAE.
