Spontaneous resolution of post-traumatic pulmonary artery pseudoaneurysm: Report of two cases
A 32-year-old male patient presented in casualty with a history of assault and civilian, high velocity gunshot injury on the right side of the chest. He developed gradually progressive shortness of breath. On clinical examination, chest compression test was positive with reduced air entry on the right side with dullness on percussion. Small penetrating wound was present over the right chest with lacerated wound in scalp. Focused assessment with sonography for trauma (FAST) scan was positive. Intercostal drainage tube (ICD) was placed and it drained about 1 L of blood. Patient was sent for CECT chest and abdomen.\nOn computed tomography (CT) scan, there was right sided hemothorax with ICD tube in situ, fracture of right 6th rib with laceration and contusion of lower lobe of the right lung. There was rounded hyperdense lesion of attenuation similar to that of the vessel and measuring 1.3 cm in the right lower lobe in continuity with a branch of descending right pulmonary artery suggesting a pseudoaneurysm [Figure and ]. Both entry and exit wound were well seen on CT images. This pseudoaneurysm was in the track of bullet and there was associated liver laceration with minimal hemoperitoneum.\nBecause of small size of pseudoaneurysm, absence of hemoptysis and stable clinical condition of patient, conservative management was planned. Follow-up CT pulmonary angiography was performed 1 week later, which revealed a significant reduction in size of pseudoaneurysm (0.7 cm) and surrounding lung contusion []. Patient was discharged on conservative treatment and was kept on clinical follow-up.