A case of Rendu-Osler-Weber disease associated with pulmonary arteriovenous fistula
A 60-year-old female was admitted with a chief complaint of left hemothorax. Chest X-ray films revealed an abnormal shadow when the pleural effusion disappeared. On the physical examination, multiple telangiectases were found at the nasal mucosa, tongue and stomach. The family history showed that her son experienced frequent episodes of epistaxis. The patient was diagnosed to have Rendu-Osler-Weber disease. CT scanning and pulmonary angiography showed an arteriovenous fistula of the left lower lobe (S10) and cerebral angiography did a small arteriovenous fistula in the cerebellum. Pulmonary partial resection was performed to prevent re-hemorrhage. Pulmonary arteriovenous fistula was 2.5 x 1.5 cm in size. It located in the left lower lobe exposing through the surface of the lung over the diaphragm. The postoperative course was uneventful and she was discharged on the 18th postoperative day without any complications.