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(Chest. 1999;115:293-300.)
© 1999 American College of Chest Physicians

Airway Obstruction Arising From Blood Clot*

Three Reports and a Review of the Literature

Keane L. Arney, MD; Marc A. Judson, MD, FCCP and Steven A. Sahn, MD, FCCP

* From the Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, Charleston, SC.

Airway obstruction due to presence of blood clot occurs in a variety of clinical settings; however, it is not always preceded by hemoptysis. The impact on respiratory function may be minimal or result in life-threatening ventilatory impairment. Three illustrative cases and a comprehensive literature review are presented. The presence of endobronchial blood clot is suggested by the clinical and radiographic findings of focal airway obstruction. The diagnosis is established by direct endoscopic evaluation. Initial efforts at removal of the airway clot, if warranted, involve lavage, suctioning, and forceps extraction through a flexible bronchoscope. If unsuccessful, further management options include rigid bronchoscopy, Fogarty catheter dislodgment of the clot, and topical thrombolytic agents.

Key Words: bronchoscopy • endobronchial blood clot • hemoptysis • respiratory failure




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Copyright © 1999 by the American College of Chest Physicians.