Thông động tĩnh mạch phổi: Báo cáo trường hợp lâm sàng

Abstract

A pulmonary arteriovenous malformation (PAVM) also known as an arteriovenous fistula, it is a rare disease. The disease is usually congenital, due to structural deficiency or abnormal dilation of the pulmonary capillaries which is mainly due to lack of capillary wall development. The majority of AVM cases are associated with Rendu-Osler-Weber syndrome (Hereditary hemorrhagic telangiectasia - HHT). PAVM rarely occurs as a result of trauma to the chest. PAVM is usually long-lasting and is often first diagnosed in adults. More than two-thirds of the lesions were found in the lower lobe, the subpleural area, and the monofocal form made up the vast majority of cases. The initial diagnosis is usually a solitary pulmonary nodule. When computed tomography of the chest with intravenous contrast injection PAVM often strongly enhances the pulmonary artery. Accurate diagnosis of solitary pulmonary nodule as PAVM will help doctors avoid transthoracic biopsies and avoid life-threatening complications. We report an incidentally discovered case of PAVM in an adult patient, confirmed by contrast-enhanced multislice computed tomography. The patient underwent laparoscopic elective resection of the lung with PAVM. The surgery was successful and the patient is in good health. The results of macroscopic and microscopic specimens after surgery are consistent with PAVM. Through the case, we want to emphasize the features of the CT images of PAVM, recommend diagnostic methods and choose appropriate treatment.