Unilateral pulmonary vein atresia presenting with recurrent hemoptysis and bronchial varices in an Ethiopian adolescent: a case report

Abstract

Background Congenital unilateral pulmonary vein atresia is a rare anomaly resulting from failure of the pulmonary vein to incorporate in the left atrium. It is a very rare cause of recurrent respiratory infections and hemoptysis requiring a high index of suspicion for proper diagnosis and management in early childhood. Case presentation We report a 13-year old Anuac (Ethiopia, Region of Gambela) male adolescent with a delayed diagnosis of isolated atresia of the left pulmonary veins despite early childhood presentation with recurrent chest infections, hemoptysis and exercise intolerance. Contrast enhanced CT of thorax with reconstructed planes confirmed the diagnosis. He underwent pneumonectomy for severe and recurrent symptoms and did well on subsequent follow ups after 6 months of pneumonectomy. Conclusion Although a rare anomaly, congenital unilateral pulmonary vein atresia should be considered in the differential diagnosis of a child presenting with recurrent chest infections, exercise intolerance and hemoptysis to facilitate early appropriate diagnosis and treatment.

Embolization treatment of right pulmonary artery agenisis with patent ductus arteriosus causing pulmonary hypertension and hemoptysis: a case report and literature review

“…Abnormal systemic circulation arteries may originate from bronchial, intercostal, intrathoracic, thyrocervical trunk, subclavian, or hypogastric arteries; fewer cases have been reported involving blood supply from coronary arteries. In children with unilateral PAA where all cardiac output flows to one lung side due to excessive blood flow increasing shear stress on endothelial cells leading to long-term decline in vascular bed elasticity as well as excessive sensitivity to vasoconstrictive substances [ 8 ]. Additionally reduced relative size of affected side’s pulmonary vascular bed along with continuous opening of systemic circulation arteries leads to increased risk for adult-onset pulmonary hypertension that tends to stabilize as open arterial numbers stabilize during adulthood [ 8 ].…”