[P2-54] Effect of Embolization on Collateral Artery of Chronic Atelectasis in Patients with Severe Motor and Intellectual Disabilities (SMID)
[Introduction] Patients with severe motor and intellectual disabilities (SMID) frequently experience pneumonia. Chronic atelectasis or abscess occasionally occurs after repetitive pneumonia, and abnormal collateral artery would extend to the area. Sudden massive hemoptysis from those arteries is life-threatening. We experienced two patients with SMID who had experienced repetitive pneumonia and needed transcatheter embolization (TE). [Case 1] 49-year-old woman. She had developed repetitive pneumonia since 7 years ago. She had chronic atelectasis at the upper lobe of her right lung. She vomited fresh blood 3 times and she needed blood transfusion. She vomited blood again 5 months later. She underwent upper gastrointestinal endoscopy, but no lesion was found. 5 months later, she vomited similarly. Examination by bronchoscopy suggested bleeding from lower airway. Chest contrasted CT revealed abnormal arteries in the atelectasis and abscess. Those arteries were the origin of bleeding. She was successfully treated by TE in emergency. [Case 2] 50-year-old woman. She had atelectasis at the lower lobe of her left lung. She vomited some fresh blood repetitively during 2 years, but we couldn’t find the origin of bleeding by endoscopic examinations. Chest contrasted CT revealed abnormal arteries. She received TE. She had shown no other haemoptysis after TE. [Conclusion] We should consider haemoptysis from collateral artery to lung, when patients who has experienced repetitive pneumonia vomit fresh blood of unknown origin. TE is minimally invasive and an effective non-surgical method to control haemoptysis. Therefore, TE may be considered as one of therapy to control haemoptysis for patients with SMID.