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Rotura intrabronquial de un aneurisma de arteria pulmonar en un paciente con enfermedad de Behçet
Pulmonary Artery Aneurysm Ruptured Into Bronchus in a Patient With Behçet's Disease
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Computerized tomography pulmonary angiography (CTPA) showed 2 lesions, originating from upper and lower branches of the left pulmonary artery (b, arrow). Contrast filling was enhanced at late phase of imaging (c, asterisk), with small air bubbles at the periphery of the lower lesion (c, arrow).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ekrem Cengiz Seyhan, Mehmet Zeki Gunluoglu, Cengiz Erol" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ekrem Cengiz" "apellidos" => "Seyhan" ] 1 => array:2 [ "nombre" => "Mehmet Zeki" "apellidos" => "Gunluoglu" ] 2 => array:2 [ "nombre" => "Cengiz" "apellidos" => "Erol" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289616000910" "doi" => "10.1016/j.arbres.2015.12.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616000910?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916300167?idApp=UINPBA00003Z" "url" => "/15792129/0000005300000001/v1_201612310030/S1579212916300167/v1_201612310030/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S0300289616000934" "issn" => "03002896" "doi" => "10.1016/j.arbres.2016.02.007" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "1341" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2017;53:30" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3260 "formatos" => array:3 [ "EPUB" => 111 "HTML" => 1855 "PDF" => 1294 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen clínica</span>" "titulo" => "Cardiomegalia, ¿o no?" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "30" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "A Big Heart! Or Not?" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1841 "Ancho" => 1979 "Tamanyo" => 391939 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Radiografía de tórax (proyección posteroanterior) en la que se observa una opacidad de gran tamaño, y el signo de la silueta cardíaca. B y C) RM y TC torácicas que muestran una masa muy heterogénea, que rodea al corazón por ambos lados. D) Radiografía de tórax (proyección posteroanterior) efectuada después de la resección quirúrgica, en la que se observa la expansión de ambos pulmones.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Margarida Torres Redondo, João Maciel, Pedro Bastos" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Margarida" "apellidos" => "Torres Redondo" ] 1 => array:2 [ "nombre" => "João" "apellidos" => "Maciel" ] 2 => array:2 [ "nombre" => "Pedro" "apellidos" => "Bastos" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212916300180" "doi" => "10.1016/j.arbr.2016.03.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916300180?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616000934?idApp=UINPBA00003Z" "url" => "/03002896/0000005300000001/v1_201612310024/S0300289616000934/v1_201612310024/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0300289616000909" "issn" => "03002896" "doi" => "10.1016/j.arbres.2015.12.010" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "1338" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2017;53:27-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2296 "formatos" => array:3 [ "EPUB" => 111 "HTML" => 1595 "PDF" => 590 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen clínica</span>" "titulo" => "Aspiración de un comprimido de calcio" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "27" "paginaFinal" => "28" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Calcium Pill Aspiration" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1323 "Ancho" => 1300 "Tamanyo" => 224665 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Planos axial (A) y frontal (B) del comprimido aspirado en la TC torácica. Aspecto broncoscópico del comprimido (C) y la intensa reacción de tejido de granulación observada tras su extracción (D).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sumedh S. Hoskote, Ali I. Saeed" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Sumedh S." "apellidos" => "Hoskote" ] 1 => array:2 [ "nombre" => "Ali I." "apellidos" => "Saeed" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212916300131" "doi" => "10.1016/j.arbr.2016.03.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916300131?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616000909?idApp=UINPBA00003Z" "url" => "/03002896/0000005300000001/v1_201612310024/S0300289616000909/v1_201612310024/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen clínica</span>" "titulo" => "Rotura intrabronquial de un aneurisma de arteria pulmonar en un paciente con enfermedad de Behçet" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "29" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ekrem Cengiz Seyhan, Mehmet Zeki Gunluoglu, Cengiz Erol" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Ekrem" "apellidos" => "Cengiz Seyhan" "email" => array:2 [ 0 => "drekremcs@gmail.com" 1 => "drekremcs@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Mehmet" "apellidos" => "Zeki Gunluoglu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Cengiz" "apellidos" => "Erol" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Chest Diseases, Medical Faculty, Medipol University, Estambul, Turquía" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Thoracic Surgery, Medical Faculty, Medipol University, Estambul, Turquía" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Radiology, Medical Faculty, Medipol University, Estambull, Turquía" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pulmonary Artery Aneurysm Ruptured Into Bronchus in a Patient With Behçet's Disease" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 602 "Ancho" => 1750 "Tamanyo" => 140547 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La radiografía de tórax mostró una opacidad localizada en la región hilar y paracardíaca izquierda (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>a, flecha). La angiografía pulmonar por tomografía computarizada, reveló 2 lesiones emergentes de las ramas superior e inferior de la arteria pulmonar izquierda (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>b, flecha). La repleción de contraste se realzó durante la fase tardía del estudio de imagen (fig. 1c, asterisco), observándose pequeñas burbujas de aire en la periferia de la lesión inferior (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>c, flecha).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Un varón de 54 años de edad al que se había diagnosticado de enfermedad de Behçet (EB) en otro hospital, hacía 5 años, fue hospitalizado en nuestro centro por hemoptisis masiva. La radiografía de tórax mostró una opacidad bilobulada y de bordes lisos en la región hilar y paracardíaca izquierda, que no ocultaba el contorno del corazón (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>a, flecha). La angiografía pulmonar por tomografía computarizada reveló 2 lesiones emergentes de las ramas superior e inferior de la arteria pulmonar izquierda, cuyas zonas centrales estaban ocupadas por material de contraste en la fase temprana del estudio de imagen (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>b, flecha). La repleción de contraste se realzó durante la fase tardía del estudio de imagen (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>c, asterisco). La periferia de la lesión inferior no era tan opaca y contenía pequeñas burbujas de aire (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>c, flecha). Estos signos sugerían la posibilidad de rotura intrabronquial de un seudoaneurisma trombosado. Se diagnosticó una rotura de un aneurisma de arteria pulmonar (AAP), y se inició tratamiento pulsado con glucocorticoides y ciclofosfamida a altas dosis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">La EB es una enfermedad inflamatoria multisistémica clasificada como vasculitis. El AAP es la principal complicación de la EB pulmonar y su pronóstico es malo, pues se asocia con hemoptisis masiva<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>. El tratamiento médico con fármacos inmunosupresores es preferible a la cirugía, porque el aneurisma o fístula recurrente en la zona de la anastomosis es una complicación frecuente de la resección quirúrgica<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a>.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 602 "Ancho" => 1750 "Tamanyo" => 140547 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La radiografía de tórax mostró una opacidad localizada en la región hilar y paracardíaca izquierda (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>a, flecha). La angiografía pulmonar por tomografía computarizada, reveló 2 lesiones emergentes de las ramas superior e inferior de la arteria pulmonar izquierda (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>b, flecha). La repleción de contraste se realzó durante la fase tardía del estudio de imagen (fig. 1c, asterisco), observándose pequeñas burbujas de aire en la periferia de la lesión inferior (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>c, flecha).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary manifestations in Behcet's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Erkan" 1 => "A. Gul" 2 => "E. Tasali" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2001" "volumen" => "56" "paginaInicial" => "572" "paginaFinal" => "578" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11413359" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[Article in French]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary arterial aneurysms revealing Behcet's disease: From diagnosis to treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Trombati" 1 => "A. Souabny" 2 => "A. Aichane" 3 => "A. Bahlaoui" 4 => "H. Afif" 5 => "Z. Bouayad" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Med Interne" "fecha" => "2002" "volumen" => "23" "paginaInicial" => "334" "paginaFinal" => "341" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11928384" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005300000001/v1_201612310024/S0300289616000910/v1_201612310024/es/main.assets" "Apartado" => array:4 [ "identificador" => "45361" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imagen clínica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005300000001/v1_201612310024/S0300289616000910/v1_201612310024/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616000910?idApp=UINPBA00003Z" ]
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