Bronchial Occlusion Using Endobronchial Watanabe Spigot for Massive Hemoptysis in a Case of Pulmonary Aspergilloma

Abstract

Background. Bronchial artery embolization (BAE) and surgery are the standard therapy for cases of massive hemoptysis. In recent years, some cases of hemoptysis treated with endobronchial occlusion using the endobronchial Watanabe spigot (EWS) have been reported. Case. An 82-year-old man undergoing treatment for idiopathic pulmonary fibrosis and pulmonary aspergilloma was referred to our hospital because of hemoptysis and hospitalized. He was treated with hemostatic agents, and the hemoptysis was initially controlled. However, on the night of hospital day 3, massive hemoptysis occurred. Due to difficulty in performing BAE, we attempted bronchial occlusion using an EWS. Bronchoscopy revealed bleeding from the right B² and B³, and an M-sized EWS was inserted into each bronchus. After bronchial occlusion, hemoptysis was completely controlled, and he was discharged on day 23 following therapy. At one year after therapy, hemoptysis has not recurred. Conclusion. Bronchial occlusion using an EWS can be effective as emergency therapy in cases of hemoptysis.