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Case Report
 
Systemic air-angiogram appearance caused by aortobronchial fistula in a cardiac arrest patient with ruptured aortic arch aneurysm
Izumi Torimoto1, Shigeo Takebayashi1, Hiroshi Manaka1, Kyota Nakamura1, Naoto Morimura1
1From the Departments of Diagnostic Radiology (IT, ST,), Neurosurgery (HM), High Care and Emergency Center (KN, NM), Yokohama City University Medical Center, Japan.

Article ID: 100002R02IT2015
doi:10.5348/R02-2015-2-CR-2

Address correspondence to:
Shigeo Takebayashi
Department of Diagnostic Radiology, Yokohama City University Medical Center
4-57, Urafune-cho, Minami-ku
Yokohama, 232-0024
Japan

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How to cite this article
Torimoto I, Takebayashi S, Manaka H, Nakamura K, Morimura N. Systemic air-angiogram appearance caused by aortobronchial fistula in a cardiac arrest patient with ruptured aortic arch aneurysm. Edorium J Radiol 2015;1:6–9.


Abstract
Introduction: We report a very rare finding of air replacement of systemic arteries appeared as air-angiogram on radiographs and multi-detector computed tomography (MDCT).
Case Report: A 70-year-old male suffered cardiac arrest after a massive hemoptysis and received endotracheal intubation and positive pressure ventilation. Chest and abdominal radiographs showed massive air in the heart, the aorta and the systemic arteries appeared as "air-angiogram". Postmortem multi-detector computed tomography images obtained shortly after death confirmed a ruptured aortic arch aneurysm and air replacement of the left heart chambers, the aorta and systematic arteries.
Conclusion: Positive pressure ventilation causes massive air embolism in the patient with aortobronchial fistula secondary to the aneurysmal rupture.

Keywords: Aortic aneurysm, Aortobronchial fistula, Cardiac arrest, Cardiopulmonary resuscitation, Ruptured aortic arch aneurysm


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Author Contributions
Izumi Torimoto – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Shigeo Takebayashi – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Hiroshi Manaka – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Kyota Nakamura – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Naoto Morimura – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Izumi Torimoto et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.