Monday, 10 December, 2018

Man Dies After Coughing Up Lung's Bronchial Tree

The man's bronchial tree Modal Trigger The man's bronchial tree. NEJM
Samantha Long | 08 December, 2018, 00:55

Last week, a hospitalized California man coughed up an intact cast of part of his right lung, a colossal blood clot almost six inches wide.

The man was on blood thinning drugs to help prevent clots, the Atlantic noted, also pointing out that this treatment can make bleeding in some areas more common.

Doctors Gavitt Woodard and Georg Wieselthaler of the University of California at San Francisco reported on the unusual occurrence in The New England Journal of Medicine in late November. He later died of complications of heart failure.

During the week, he had been coughing up blood and mucus, increasing the strain on his lungs.

"An Impella ventricular assist device was placed for management of acute heart failure, and a continuous heparin infusion was initiated for systemic anticoagulation".

Over the course of a week, the patient had progressed to coughing up phlegm and blood, and during a particularly extreme bout coughed up an intact cast of the right bronchial tree.

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The pulmonary surgeon caring for the 36-year-old told The Atlantic the patient then needed further care.

A man who went into the hospital with heart problems ended up literally coughing up a lung.

Doctors aren't quite sure how the clot stayed intact while being coughed up, but Dr Wieselthaler suspects it could be due to the patient's higher level of fibringen in his blood, which acts like a glue.

Sadly, the patient died from complications of heart failure almost a week later.

Bronchial tree clots (called casts) are actually relativelycommon but only in extremely rare cases do they emerge in such pristine condition.

Wieselthaler's colleague, Dr. Gavitt Woodard, a clinical fellow at UCSF, told the Atlantic that one reason they made a decision to publish the image was to show the "beautiful anatomy of the human body".

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