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Nótese la presencia de cambios inflamatorios en el seno costofrénico derecho (flecha). B) Reconstrucción proyección de intensidad máxima (MIP) coronal de la angio-TC de tórax y abdomen superior en la que se visualiza una comunicación entre una arteria frénica inferior derecha hipertrófica (flecha negra) y una arteria subsegmentaria pulmonar del lóbulo inferior derecho (flecha blanca). C) Reconstrucción volumétrica <span class="elsevierStyleItalic">(volume rendering)</span> de la angio-TC de la fístula sistémico pulmonar (las flechas cortas señalan la arteria frénica inferior derecha mientras que las largas señalan la arteria pulmonar). D) Arteriografía en la que se visualiza el llenado retrógrado de las arterias pulmonares (flechas largas) desde la arteria frénica inferior derecha hipertrófica y tortuosa (flechas cortas).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sara Fra Fernández, Luis Gorospe Sarasúa, Andreina Olavarría Delgado, Diurbis Velasco Álvarez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Sara" "apellidos" => "Fra Fernández" ] 1 => array:2 [ "nombre" => "Luis" "apellidos" => "Gorospe Sarasúa" ] 2 => array:2 [ "nombre" => "Andreina" "apellidos" => "Olavarría Delgado" ] 3 => array:2 [ "nombre" => "Diurbis" "apellidos" => "Velasco Álvarez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212919300126" "doi" => "10.1016/j.arbr.2019.02.003" "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/S1579212919300126?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289618302941?idApp=UINPBA00003Z" "url" => "/03002896/0000005500000004/v1_201904020619/S0300289618302941/v1_201904020619/es/main.assets" ] ] "itemAnterior" => array:19 [ "pii" => "S1579212919300114" "issn" => "15792129" "doi" => "10.1016/j.arbr.2019.02.002" "estado" => "S300" "fechaPublicacion" => "2019-04-01" "aid" => "1955" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2019;55:225-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 204 "formatos" => array:3 [ "EPUB" => 50 "HTML" => 91 "PDF" => 63 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Usefulness of Thoracic Ultrasound in the Diagnosis of Intercostal Pulmonary Hernias" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "225" "paginaFinal" => "226" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilidad de la ecografía torácica en el diagnóstico de las hernias pulmonares intercostales" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1427 "Ancho" => 1750 "Tamanyo" => 201835 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A–C) Series of follow-up CTs showing a left laterobasal peripheral pulmonary opacity with minor extension to the intercostal space gradually increasing in size and density (black arrows). (D) Chest ultrasound (Valsalva maneuver) showing a hyperechogenic lesion (white arrows) in the intercostal space between the lateral arches of the left seventh and eighth ribs (double white arrows), which mobilized during respiration. (E) Lesion protruding significantly toward the chest wall during the Valsalva maneuver. The patient was diagnosed with intercostal pulmonary hernia probably associated with thoracoscopy entry port for performing left upper lobectomy</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Diego Varona Porres, Esther Pallisa, Ana Lucía Sánchez, Oscar Persiva" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Diego" "apellidos" => "Varona Porres" ] 1 => array:2 [ "nombre" => "Esther" "apellidos" => "Pallisa" ] 2 => array:2 [ "nombre" => "Ana Lucía" "apellidos" => "Sánchez" ] 3 => array:2 [ "nombre" => "Oscar" "apellidos" => "Persiva" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289618302862" "doi" => "10.1016/j.arbres.2018.06.020" "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/S0300289618302862?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919300114?idApp=UINPBA00003Z" "url" => "/15792129/0000005500000004/v1_201904020619/S1579212919300114/v1_201904020619/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Systemic-to-Pulmonary Artery Fistula as a Late Complication of Biliary Surgery" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "227" "paginaFinal" => "228" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Sara Fra Fernández, Luis Gorospe Sarasúa, Andreina Olavarría Delgado, Diurbis Velasco Álvarez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Sara" "apellidos" => "Fra Fernández" "email" => array:1 [ 0 => "sarafrafernandez@gmail.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" => "Luis" "apellidos" => "Gorospe Sarasúa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Andreina" "apellidos" => "Olavarría Delgado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Diurbis" "apellidos" => "Velasco Álvarez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fístula arterio-arterial sistémico-pulmonar como complicación tardía de cirugía biliar" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2247 "Ancho" => 2578 "Tamanyo" => 610904 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Axial abdominal CT image showing a mass in the anterior mediastinum (asterisk). Note the presence of inflammatory changes in the right costophrenic sinus (arrow). (B) Maximum intensity projection (MIP) coronal reconstruction of the CT angiogram of the chest and upper abdomen showing a communication between a hypertrophic right inferior phrenic artery (black arrow) and a subsegmental pulmonary artery in the right lower lobe (white arrow). (C) Volume rendering of CT angiogram of the systemic-pulmonary fistula (short arrows indicate right inferior phrenic artery, while long arrows indicate the pulmonary artery). (D) Angiogram showing retrograde filling of pulmonary arteries (long arrows) from a tortuous, hypertrophic right inferior phrenic artery (short arrows).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Anastomosis between the systemic and pulmonary circulation can be congenital or acquired. Approximately 15% of systemic-pulmonary fistulas (SPF) are congenital, and associated with heart disease or hypoplasia of the pulmonary artery.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> Acquired SPF, the most common kind, may be due to inflammation, infection, trauma, surgery, or cancer, among others. SPF mostly occur between a bronchial artery and subsegmental branches of the pulmonary artery. Exceptionally, arterio-arterial anastomosis can occur between abdominal systemic arteries (hepatic artery or inferior phrenic artery) and pulmonary arteries.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> We report the case of SPF between an abdominal systemic artery (right inferior phrenic artery) and a pulmonary artery as a late complication of a biliary surgery.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Our patient was a 79-year-old man who consulted due to repeated, self-limiting episodes of hemoptysis. Significant history included laparoscopic cholecystectomy compounded with a right subphrenic abscess (resolved with drainage and antibiotics) 2 years previously (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). Hemoptysis originating in the upper airway and digestive tract was ruled out by fiberoptic bronchoscopy and gastrointestinal endoscopy, but in a computed tomography (CT) scan of the chest with contrast medium, an opacity was identified in the right postero-basal segment in contact with the diaphragmatic surface that was surrounded by characteristically tortuous vessels. Given these findings, suggestive of a vascular malformation, we decided to perform an CT angiogram of the chest, which confirmed the existence of an SPF between a hypertrophic right inferior phrenic artery and a subsegmental branch of the pulmonary artery of the right lower lobe (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B and <span class="elsevierStyleSmallCaps">C</span>). This SPF was treated by selective embolization with Onyx<span class="elsevierStyleSup">®</span> (an ethylene vinyl alcohol copolymer) of the systemic feeding artery of the right inferior phrenic artery (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D). There have been no subsequent complications nor have any new episodes of hemoptysis occurred to date.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">SPF are abnormal anastomosis between systemic arteries and pulmonary vessels; they may be congenital or, more frequently, acquired. The latter usually occur in the presence of pleural adhesions as a result of various long-standing inflammatory processes of the chest, such as bronchiectasis (particularly in patients with cystic fibrosis), tuberculosis, or chronic empyema. These processes are often associated with pleural fibrosis and the resulting decrease in pulmonary blood flow, which cause hypertrophy of the systemic arteries. Although several cases of SPF due to surgical interventions have been described (aortocoronary bypass surgery, thoracotomies, and video-assisted thoracoscopic surgery), very few cases have been reported in association with abdominal surgery.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1,3</span></a> In most cases, SPF are asymptomatic, although one of the most common presenting symptoms is hemoptysis. Other less common symptoms have been described, such as dyspnea or chronic chest pain, and complicated cases with pulmonary hypertension or endocarditis have also been documented. This disease can be diagnosed with CT angiogram or arteriography, and several treatment options are available: surgery, endovascular treatment (embolization), or observation. In patients like ours, with repeated episodes of moderate hemoptysis, embolization is often the first-choice treatment.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In conclusion, the SPF secondary to biliary surgery are exceptional. For this reason, when a fistula in an inferior phrenic artery is observed in a patient with hemoptysis, the index of suspicion should be high, and the patient's history and previous tests should be reviewed to correctly identify its cause.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Fra Fernández S, Gorospe Sarasúa L, Olavarría Delgado A, Velasco Álvarez D. Fístula arterio-arterial sistémico-pulmonar como complicación tardía de cirugía biliar. Arch Bronconeumol. 2019;55:227–228.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2247 "Ancho" => 2578 "Tamanyo" => 610904 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Axial abdominal CT image showing a mass in the anterior mediastinum (asterisk). Note the presence of inflammatory changes in the right costophrenic sinus (arrow). (B) Maximum intensity projection (MIP) coronal reconstruction of the CT angiogram of the chest and upper abdomen showing a communication between a hypertrophic right inferior phrenic artery (black arrow) and a subsegmental pulmonary artery in the right lower lobe (white arrow). (C) Volume rendering of CT angiogram of the systemic-pulmonary fistula (short arrows indicate right inferior phrenic artery, while long arrows indicate the pulmonary artery). (D) Angiogram showing retrograde filling of pulmonary arteries (long arrows) from a tortuous, hypertrophic right inferior phrenic artery (short arrows).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Secondary systemic artery to pulmonary artery and pulmonary vein fistulas following the video-assisted thoracic surgery for pneumothorax: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T. Shimmyo" 1 => "T. Omori" 2 => "A. Hirano" 3 => "M. 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Quispe Atuncar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2002" "volumen" => "38" "paginaInicial" => "95" "paginaFinal" => "98" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11844443" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005500000004/v1_201904020619/S1579212919300126/v1_201904020619/en/main.assets" "Apartado" => array:4 [ "identificador" => "49861" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005500000004/v1_201904020619/S1579212919300126/v1_201904020619/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919300126?idApp=UINPBA00003Z" ]
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