Hemothorax Due to Aneurysm of the Left Pulmonary Vein in a Pregnant Patient. Case Report

Abstract

Pulmonary venous aneurysm often presents as a mediastinal mass, in most cases patients are asymptomatic and surgical treatment is not required unless there are complications. We present the case of a 34-year-old woman, with a normal evolutionary pregnancy of 36 weeks of gestation, with dyspnea on small to medium efforts, to which was added pleuritic pain in the left hemithorax, evidence of left pleural effusion greater than 80%, with drainage of 700 ml of hematic fluid. The gynecology and obstetrics service identified anhydramnios, deciding to terminate the pregnancy through the abdomen. A simple and contrast- enhanced chest tomography was performed, as well as papanicolaou staining of pleural fluid with a negative report for malignancy. The angiotomography reported an aneurysm of the left lobar vein with a fistulous tract, so cardiothoracic surgery performed resection of the saccular aneurysm by thoracotomy without complications. Pulmonary vein aneurysms are such rare lesions that there are no data in the literature to predict their natural history or pathogenesis. During pregnancy, cardiovascular causes of mortality predominate; on this spectrum, hemothorax could be a true surgical emergency.