Massive hemoptysis due to recurrence of bronchial to pulmona
A Dieulafoy is a vascular malformation described as a dilated, tortuous artery which protrudes into the submucosa.
Bronchial dieulafoy lesions are quite rare with relatively few case reports in the literature. Symptoms may vary but the lesion is often associated with hemoptysis and may present as massive hemoptysis.

Published in the Respiratory Medicine Case Reports, the authors present a case of a 69-year-old male with a recurrent episode of hemoptysis three years after treatment for a bronchial dieulafoy lesion.

The bronchoscopy done three years prior during an initial episode of hemoptysis showed a visible dieulafoy deep within a subsegmental branch of the right lower lobe. This case is unique because there are no other reports within the literature of a delayed recurrence several years after previous treatment of a bronchial dieulafoy lesion, which in this case was due to bronchial to pulmonary vascular malformation.

Bronchial arteriography revealed a bronchial artery to pulmonary artery vascular malformation, which was successfully treated with coil embolization.

Key takeaways:-
- Treatment of a bronchial dieulafoy depends on location of lesion, presentation and local expertise. As demonstrated in prior case reports, angiography with arterial embolization is recommended, which was used for this patient with a successful outcome.

- In the case of failed embolization attempts by technical failures or unsuccessful cannulations, surgical resection may be required.

- Additional treatment modalities have also been used such as cauterization or argon plasma coagulation and cryotherapy


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