A Case of Cryptogenic Hemoptysis after General Anesthesia

Hemoptysis after general anesthesia is common, and is believed to be a consequence of surgical error or the anesthesia itself. Despite complete evaluation, 20-30% of cases of hemoptysis remain without an identified etiology and are considered cryptogenic hemoptysis. Perioperative cryptogenic hemoptysis has rarely been reported in the literature. Herein, we report the case of a patient who expectorated fresh blood intermittently, and a large blood clot after an uneventful cervical spine surgery under general anesthesia. Extensive evaluation including chest X-ray, computed tomography (CT), and bronchoscope identified active oozing from the left lingual segmental bronchus only. The differential diagnosis of perioperative hemoptysis and its management are discussed. The prognosis of cryptogenic hemoptysis is favorable, but hemoptysis may recur. Complete prompt evaluation is important, especially for patients with a risk of malignancy.