The man coughed up 300 ml of blood due to complications from pulmonary tuberculosis.

The patient coughed up a whole cup of bright red blood, experienced shortness of breath, and felt dizzy. Doctors at Tam Anh General Hospital successfully performed emergency surgery to stop the bleeding.

On June 15th, Dr. Dang Thi Mai Khue, from the General Internal Medicine Department of Tam Anh General Hospital in Ho Chi Minh City, reported that Mr. Le Van Minh (71 years old, Ho Chi Minh City) was admitted to the emergency room with symptoms of coughing up large amounts of bright red blood, shortness of breath, dizziness, and fatigue. This was the first time he had experienced coughing up blood, with an amount of approximately 300 ml.
The CT scan results showed that the patient had bronchiectasis with increased bronchial vascularity as a sequela of pulmonary tuberculosis, leading to hemoptysis (coughing up blood).

Doctors stopped the bleeding for Mr. Minh using flexible endoscopy to aspirate blood and perform vascular intervention under DSA guidance. The patient coughed up all the dark clotted blood (also known as anticoagulant tails), clearing his lungs. Currently, Mr. Minh's health is stable, and he has been discharged home to rest and avoid strenuous activity. He will have regular follow-up appointments and has been advised to get flu shots, pneumococcal vaccinations, etc., to prevent a recurrence of coughing up blood.

Before and after images of bronchoscopy with blood aspiration for a patient. Photo: Tam Anh General Hospital .

According to Dr. Mai Khue, medical intervention for a case of hemoptysis with a large amount of blood and ongoing bleeding is very difficult. In such cases, if medical intervention fails, surgery must be applied. After treatment, if Mr. Minh continues to cough up blood, a consultation will be held to consider surgical removal of the dilated section of the bronchus. At that time, the doctors will assess whether the lung function meets the criteria for surgery.

Bronchiectasis is a condition characterized by irreversible dilation of a portion of the bronchial tree, and is a common sequela of pulmonary tuberculosis. Hemoptysis (coughing up blood) is a symptom and complication of bronchiectasis because the blood vessels in the bronchial walls become dilated and rupture.

Dr. Mai Khue examines a patient after a successful medical hemostasis procedure. Photo: Tam Anh General Hospital.

In cases where a patient experiences hemoptysis due to bronchiectasis as a sequela of pulmonary tuberculosis, medical hemostatic treatment will be applied. The doctor will reassess whether the patient has been reinfected with tuberculosis to determine the appropriate treatment.

Individuals with a history of pulmonary tuberculosis should seek medical attention. Excessive coughing up blood can flood the lungs, leading to severe hemoptysis, acute respiratory failure, and respiratory arrest.

Kim Thanh

The patient's name has been changed.

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