LIFE-THREATENING HEMOPTYSIS IN PRIMARY LUNG ABSCESS

Abstract Seven patients developed life-threatening hemoptysis while receiving medical treatment for primary lung abscesses. The first 6 patients all underwent pulmonary resection. One of these patients died; he was 1 of 2 who had had a second episode of hemoptysis before being operated upon. The next 4 patients were operated upon after the first episode; all did well. All 6 of the operated group had roentgenograms that showed one or more of three patterns: (1) emptying-refilling, (2) air-fluid level to movable mass, and (3) persistent radiodensity. Each of these patterns reflects the presence of blood clots in the abscess cavity. A seventh patient died during his first episode of hemoptysis two weeks after he showed the emptying-refilling pattern on chest roentgenograms. Our experience with these 7 patients suggests that if a patient with a primary lung abscess has either life-threatening hemoptysis or roentgenographic evidence of blood clots within the abscess cavity, he should undergo pulmonary resection.