CASE REPORT
The forgotten bomb: Ramussens’s aneurysm
 
More details
Hide details
1
Department of Radiology, Siverek State Hospital, Şanlıurfa, Turkey
 
2
Department of Radiology, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
 
3
Department of Radiology, School of Medicine, Cukurova University, Adana, Turkey
 
4
Department of Pediatrics, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey
 
 
Submission date: 2022-01-18
 
 
Final revision date: 2022-07-05
 
 
Acceptance date: 2022-07-06
 
 
Online publication date: 2022-09-20
 
 
Corresponding author
Hüseyin Akkaya   

Şanlıurfa District , 63600, Siverek State of Hospital, Siverek, Şanlıurfa, Turkey. Tel.:+90 5348454217.
 
 
Pol. Ann. Med. 2023;30(1):50-53
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Rasmussen’s aneurysm is an inflammatory pseudoaneurysmal dilatation of a branch of the pulmonary artery adjacent to the tuberculous cavity. It often presents with hemoptysis resulting from its rupture. Massive hemoptysis seen in giant aneurysms is a rare but life-threatening complication of cavitary tuberculosis.

Aim:
In this case, we aimed to present a case of giant rasmussen aneurysm that did not bleed and was diagnosed incidentally.

Case study:
In this article, we present a female patient who was surprisingly diagnosed with Rasmussen’s aneurysm during her follow-up after having been admitted to our emergency department due to diabetic ketoacidosis, fever, and shortness of breath and not responding to tuberculosis treatment. She was diagnosed using multi-detector computed tomography angiography and underwent embolization with a percutaneous thrombin injection. On the day after the procedure, thoracotomy had to be performed because the pseudoaneurysm continued to show contrast enhancement on imaging. She was successfully treated with surgery.

Results and discussion:
Although pulmonary artery aneurysms are rare, it should be kept in mind that they may be related to tuberculosis. Pulmonary artery aneurysms are large asymptomatic and can reach gigantic dimensions as in this case. Rupture of an aneurysm of this size can be predicted to be mortal. Percutaneous thrombin injection can be used for treatment. However, percutaneous treatment may recur in large aneurysms, in which case surgical treatment is curative.

Conclusions:
Rasmussen aneurysm is very rare, and when it is asymptomatic, its diagnosis may be delayed until it reaches gigantic dimensions. Contrast-enhanced thorax computed tomography and especially multi-detector computed tomography angiography are helpful in diagnosis.

FUNDING
This study has no funding.
CONFLICT OF INTEREST
The authors declare that they have no conflict of interest.
 
REFERENCES (14)
1.
Nachiappan AC, Rahbar K, Shi X, et al. Pulmonary tuberculosis: Role of radiology in diagnosis and management. Radiographics. 2017;37(1):52–72. https://doi.org/10.1148/rg.201....
 
2.
Bruzzi JF, Rémy-Jardin M, Delhaye D, Teisseire A, Khalil C, Rémy J. Multi-detector row CT of hemoptysis. Radiographics. 2006;26(1):3–22. https://doi.org/10.1148/rg.261....
 
3.
Giraldo-Montoya ÁM, Rodríguez-Morales AJ, Hernández-Hurtado JD, López-Salazar Á, Lagos-Grisales GJ, Ruiz-Granada VH. Rasmussen aneurysm: A rare but not gone complication of tuberculosis. Int J Infect Dis. 2018;69:8–10. https://doi.org/10.1016/j.ijid....
 
4.
Cajigas-Loyola SC, Miller RL, Spieler B, Carbonella G. Mycotic pulmonary artery aneurysm mimicking a Rasmussen Aneurysm. Ochsner J. 2018;18(1):104–107.
 
5.
Castañeda-Hernández DM, Bolívar-Mejía A, Rodríguez-Morales AJ. Epidemiology of tuberculosis among homeless persons. Infectio. 2013;17(1):48–49.
 
6.
Corr P. Pulmonary artery aneurysm as a cause of massive hemoptysis: diagnosis and management. Case Rep Radiol. 2011;141563. https://doi.org/10.1155%2F2011....
 
7.
Kim HY, Song KS, Goo JM, Lee JS, Lee KS, Lim TH. Thoracic sequelae and complications of tuberculosis. Radiographics. 2001;21(4):839–858. https://doi.org/10.1148/radiog....
 
8.
Rajamannar KV, Kilaru H, Aravelly S, Gudipati AR, Kilaru SC. Massive hemoptysis from Rasmussen's aneurysm in active pulmonary tuberculosis; A case report of successful treatment with bronchial artery embolization. Respir Med Case Rep. 2017;22:277–279. https://doi.org/10.1016/j.rmcr....
 
9.
Syed M, Irby J. Airway management of ruptured pulmonary artery ‘Rasmussen’ aneurysm and massive hemoptysis. BMC Res Notes. 2015;8 (12):346. https://doi.org/10.1186/s13104....
 
10.
Halezeroğlu S, Okur E. Thoracic surgery for haemoptysis in the context of tuberculosis: what is the best management approach? J Thorac Dis. 2014;6(3):182–185. https://doi.org/10.3978/j.issn....
 
11.
Keeling AN, Costello R, Lee MJ. Rasmussen's aneurysm: a forgotten entity? Cardiovasc Intervent Radiol. 2008;31(1):196–200. https://doi.org/10.1007/s00270....
 
12.
Chatterjee K, Colaco B, Colaco C, Hellman M, Meena N. Rasmussen’s aneurysm: a forgotten scourge. Respir Med Case Rep. 2015;16:74–76. https://doi.org/10.1016/j.rmcr....
 
13.
Jaureguizar Oriol A, Ayala Carbonero AM, Gorospe Sarasúa L. Life-threatening hemoptysis secondary to Rasmussen's aneurysm in an HIV patient. Arch Bronconeumol. 2016;52(8):439–440. https://doi.org/10.1016/j.arbr....
 
14.
Picard C, Parrot A, Boussaud V. Massive hemoptysis due to Rasmussen aneurysm: detection with helicoidal CT angiography and successful steel coil embolization. Intensive Care Med. 2003;29(10):1837–1839.
 
Journals System - logo
Scroll to top