Bronchial cast extrication in an intubated and ventilated pa
A man who went to the doctor with back pain and a fever has died following the discovery of a 7.8-inch blood clot in his lungs.

The coagulated blood, which was pulled from the 64-year-old patient’s breathing tube, kept the furcated shape of the lung’s airways. Doctors at a London hospital run by Imperial College Healthcare published an account of the patient’s condition in BMJ Case Reports.

When the man arrived at the hospital, his blood pressure was “profoundly low,” according to Dr. Charles Coughlan’s report. Chest scans revealed the pulmonary embolism as well as rising fluid in his lungs. They drained a “large volume” from his chest, but soon the man began coughing blood.

A bronchoscopy showed a “large pale blood clot” stuck inside the patient’s breathing tube, which had been inserted directly into the man’s lung to aid breathing.

“Despite multiple attempts, this could not be removed by suction,” wrote Coughlan, who referred to the clot as a “bronchial cast,” meaning it was molded to the shape of the airway in which it originated.

Physicians were forced to sedate and paralyze the patient to be able to remove the clot from the tube. The man’s breathing recovered “immediately,” but latent illness had taken a toll on his body. Further tests revealed that the man, who had had a heart valve replacement in the past, also suffered from bowel cancer, septic shock and a powerful staph infection, Methicillin-resistant Staphylococcus aureus (MRSA), in his cardiac muscle.

Doctors determined that further treatment of his fragile body would be futile, and, with the family’s permission, turned off the man’s life support.

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