WordNet

coughing up blood from the respiratory tract; usually indicates a severe infection of the bronchi or lungs (同)haemoptysis

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/08 20:02:58」(JST)

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Hemoptysis^[a] in American English, spelled haemoptysis in British English, is the act of coughing up blood or blood-stained mucus from the bronchi, larynx, trachea, or lungs. This can occur with lung cancer, infections such as tuberculosis, bronchitis, or pneumonia, and certain cardiovascular conditions. Hemoptysis is considered massive if there is more than 300 mL (11 imp fl oz; 10 US fl oz) of blood lost in 24 hours. In such cases, the primary danger comes from choking, rather than blood loss.^[1]

Differential diagnosis

There are many conditions involving hemoptysis, including but not limited to bronchitis and pneumonia most commonly, but also lung cancers (in smokers, hemoptysis is often persistent), aspergilloma, tuberculosis, bronchiectasis, coccidioidomycosis, pulmonary embolism, pneumonic plague, and cystic fibrosis. Rarer causes include hereditary hemorrhagic telangiectasia (HHT or Rendu-Osler-Weber syndrome), Goodpasture's syndrome, and granulomatosis with polyangiitis. In children, hemoptysis is commonly caused by the presence of a foreign body in the airway. The condition can also result from over-anticoagulation from treatment by drugs such as warfarin.

Blood-laced mucus from the sinus or nose area can sometimes be misidentified as symptomatic of hemoptysis (such secretions can be a sign of nasal or sinus cancer, but also a sinus infection). Extensive non-respiratory injury can also cause one to cough up blood. Cardiac causes like congestive heart failure and mitral stenosis should be ruled out.

The origin of blood can be identified by observing its color. Bright-red, foamy blood comes from the respiratory tract, whereas dark-red, coffee-colored blood comes from the gastrointestinal tract. Sometimes hemoptysis may be rust-colored.

The most common cause of minor hemoptysis is bronchitis.^[2]

Lung cancer, including both non-small cell lung carcinoma and small cell lung carcinoma.^[3]^[4]
Sarcoidosis^[5]
Aspergilloma^[6]
Tuberculosis^[7]
Histoplasmosis^[8]
Pneumonia
Pulmonary edema
Pulmonary embolism
Foreign body aspiration and aspiration pneumonia
Goodpasture's syndrome^[9]
Granulomatosis with polyangiitis^[10]
Eosinophilic granulomatosis with polyangitis (Churg-Strauss syndrome)
Bronchitis^[11]
Bronchiectasis^[11]
Pulmonary embolism^[12]
Anticoagulant use^[12]
Trauma^[12]
Lung abscess^[12]
Mitral stenosis
Tropical eosinophilia
Bleeding disorders
Hughes-Stovin Syndrome and other variants of Behçet's disease

Diagnosis

Diagnostic approach to solving the puzzle of hemoptysis.

Past history, history of present illness, family history
- history of tuberculosis, bronchiectasis, chronic bronchitis, mitral stenosis, etc.
- history of cigarette smoking, occupational diseases by exposure to silica dust, etc.
Blood
- duration, frequency, amount
- Amounts of blood: large amounts of blood, or is there blood-streaked sputum
- Probable source of bleeding: Is the blood coughed up, or vomited?
Bloody sputum
- color, characters: blood-streaked, fresh blood, frothy pink, bloody gelatinous.
Accompanying symptoms
- fever, chest pain, coughing, purulent sputum, mucocutaneous bleeding, jaundice.
Imaging examination
- chest X-ray, CT scan and 3D reconstruction images or CT virtual bronchoscopy, bronchial angiography.
Laboratory tests
- blood test: WBC
- Sputum: cells and bacterial examinations, sputum culture
Bronchial fiber endoscopy^[13]

Treatment

Treatment depends on the underlying cause. Treatments include iced saline, and topical vasoconstrictors such as adrenalin or vasopressin. Selective bronchial intubation can be used to collapse the lung that is bleeding. Also, endobronchial tamponade can be used. Laser photocoagulation can be used to stop bleeding during bronchoscopy. Angiography of bronchial arteries can be performed to locate the bleeding, and it can often be embolized.^[14] Surgical option is usually the last resort, and can involve, removal of a lung lobe or removal of the entire lung. Non–small-cell lung cancer can also be treated with erlotinib or gefitinib.^[15] Cough suppressants can increase the risk of choking. ^[16]

Notes

^ Pronounced /hᵻˈmɒptᵻsɪs/ and also known as emptysis.

References

^ Sabatine, [edited by] Marc S. (2014). Pocket medicine (Fifth edition. ed.). [S.l.]: Aspen Publishers, Inc. ISBN 1451193785.
^ Sabatine, [edited by] Marc S. (2014). Pocket medicine (Fifth edition. ed.). [S.l.]: Aspen Publishers, Inc. ISBN 1451193785.
^ Google Health â€“ Google
^ Google Health â€“ Google
^ Sarcoidosis Signs & Symptoms - Sarcoidosis - HealthCommunities.com
^ MedlinePlus Encyclopedia Pulmonary aspergilloma
^ Google Health â€“ Google
^ Histoplasmosis Symptoms - Diseases and Conditions - Mayo Clinic
^ Pediatric Goodpasture Syndrome at eMedicine
^ Wegener's granulomatosis Symptoms - Diseases and Conditions - Mayo Clinic
^ ^a ^b Hemoptysis Causes - Hemoptysis - HealthCommunities.com
^ ^a ^b ^c ^d Other Causes of Hemoptysis - Hemoptysis - HealthCommunities.com
^ Richard F.LeBlond. Diagnostics. US: McGraw-Hill Companies, Inc. ISBN 0-07-140923-8.
^ Uppsala Academic Hospital > Guidelines for treatment of acute lung diseases. August 2004. Authors: Christer Hanson, Carl-Axel Karlsson, Mary Kämpe, Kristina Lamberg, Eva Lindberg, Lavinia Machado Boman, Gunnemar Stålenheim
^ Welcome to Elgg
^ Sabatine, [edited by] Marc S. (2014). Pocket medicine (Fifth edition. ed.). [S.l.]: Aspen Publishers, Inc. ISBN 1451193785.

External links

Haemoptysis at GPnotebook

UpToDate Contents

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1. 成人における喀血の病因および評価 etiology and evaluation of hemoptysis in adults
2. 小児における喀血 hemoptysis in children
3. 大量喀血の概要 overview of massive hemoptysis
4. 大量喀血：初期マネージメント massive hemoptysis initial management
5. 大量喀血：原因 massive hemoptysis causes

English Journal

The development of large-cell carcinoma in the wall of a giant bulla complicated by hemorrhage.

Nakamura S1, Kawaguchi K2, Fukui T2, Fukumoto K2, Okasaka T2, Yokoi K2.
Surgical case reports.Surg Case Rep.2016 Dec;2(1):22. doi: 10.1186/s40792-016-0151-8. Epub 2016 Mar 10.
There were a few reports of patients with lung cancer developing at the wall of giant bullae complicated with hemorrhage. A 40-year-old male with complaints of hemoptysis was referred to our hospital, and a solitary pulmonary mass was pointed out on his chest roentgenogram. Computed tomography (CT)
PMID 26964998

Flat detector C-arm CT-guidance system in performing percutaneous transthoracic needle biopsy of small (≤3 cm) pulmonary lesions.

Jiao DC1, Li ZM1, Yuan HF1, Zhang QH1, Ren JZ1, Zhou PL1, Wu G1, Han XW2.
Acta radiologica (Stockholm, Sweden : 1987).Acta Radiol.2016 Jun;57(6):677-83. doi: 10.1177/0284185115603419. Epub 2015 Sep 16.
BACKGROUND: Nowadays, flat detector (FD) equipped angiographic C-arm computed tomography (CACT) systems can be used to acquire CT-like cross-sectional images directly within the interventional suite. The CACT systems offer real time visualization of transthoracic needle biopsy (TNB) procedure and mo
PMID 26377260

Staphylococcus aureus Community-acquired Pneumonia: Prevalence, Clinical Characteristics, and Outcomes.

Self WH1, Wunderink RG2, Williams DJ1, Zhu Y1, Anderson EJ3, Balk RA4, Fakhran SS5, Chappell JD1, Casimir G1, Courtney DM2, Trabue C6, Waterer GW7, Bramley A8, Magill S8, Jain S8, Edwards KM1, Grijalva CG1.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.Clin Infect Dis.2016 May 8. pii: ciw300. [Epub ahead of print]
BACKGROUND: Prevalence of Staphylococcus aureus community-acquired pneumonia (CAP) and its clinical features remain incompletely understood, complicating empirical selection of antibiotics.METHODS: Using a multicenter prospective surveillance study of adults hospitalized with CAP, we calculate
PMID 27161775

Japanese Journal

研究・症例特発性気道出血における喫煙と血圧の影響

日本胸部臨床 75(8), 914-921, 2016-08
NAID 40020926065

研究・症例エドキサバントシル酸水和物が一因と考えられた気道出血の1例

日本胸部臨床 75(8), 908-913, 2016-08
NAID 40020925854

研究・症例 30年間少量の喀血を繰り返したのちに診断された成人発症の特発性肺ヘモジデローシスの1例

日本胸部臨床 75(7), 786-793, 2016-07
NAID 40020896233

Related Pictures

Hemoptysis Hemoptysis - Pictures, posters, news and videos on your pursuit, hobbies, interests Hemoptysis - Examination and Evaluation | Epomedicine Cough & hemoptysis & cyanosis & clubbing AAEM Resident and Student Association : Drowning in your own Blood: Managing Massive

★リンクテーブル★

リンク元	「喀血」「ptysis」「spitting blood」

「喀血」

Hemoptysis
Classification and external resources
Specialty	Pulmonology
ICD-10	R04.2
ICD-9-CM	786.30
DiseasesDB	5578
MedlinePlus	003073
Patient UK	Hemoptysis
MeSH	D006469
	[edit on Wikidata]

　　[★]

英: hemoptysis　← ptysis
関: 血痰

概念

下気道由来の血液であり、咳とともに喀出される泡沫状、鮮紅色の血液　⇔　吐血：嘔吐、暗赤色の血液　　喀痰：痰のなかに血液が混在して喀出される

病因

気道病変	気管支炎気管支拡張症腫瘍気道異物気道損傷気管支血管瘻
肺実質病変	肺感染症免疫異常肺挫傷
肺血管性出血	肺動静脈瘻肺血栓塞栓症拝上脈圧上昇血管カテーテル時の肺血管損傷
その他	子宮内膜症凝固異常医原性特発性

治療

気道確保(窒息を回避する)、呼吸・循環管理、出血源の同定、原疾患の診断と止血

「ptysis」

　　[★]

comb. form

つばを吐くこと、吐出、喀出

ex.

hemoptysis 喀血

「spitting blood」

　　[★]

喀血

関: haemoptysis、hemoptysis

[1] Pronounced /hᵻˈmɒptᵻsɪs/ and also known as emptysis.

[2] Sabatine, [edited by] Marc S. (2014). Pocket medicine (Fifth edition. ed.). [S.l.]: Aspen Publishers, Inc. ISBN 1451193785.

[3] Sabatine, [edited by] Marc S. (2014). Pocket medicine (Fifth edition. ed.). [S.l.]: Aspen Publishers, Inc. ISBN 1451193785.

[4] Google Health â€“ Google

[5] Google Health â€“ Google

[6] Sarcoidosis Signs & Symptoms - Sarcoidosis - HealthCommunities.com

[7] MedlinePlus Encyclopedia Pulmonary aspergilloma

[8] Google Health â€“ Google

[9] Histoplasmosis Symptoms - Diseases and Conditions - Mayo Clinic

[10] Pediatric Goodpasture Syndrome at eMedicine

[11] Wegener's granulomatosis Symptoms - Diseases and Conditions - Mayo Clinic

[pulmonologychannel.com-12] Hemoptysis Causes - Hemoptysis - HealthCommunities.com

[pulmonologychannel-13] Other Causes of Hemoptysis - Hemoptysis - HealthCommunities.com

[14] Richard F.LeBlond. Diagnostics. US: McGraw-Hill Companies, Inc. ISBN 0-07-140923-8.

[uppsala-15] Uppsala Academic Hospital > Guidelines for treatment of acute lung diseases. August 2004. Authors: Christer Hanson, Carl-Axel Karlsson, Mary Kämpe, Kristina Lamberg, Eva Lindberg, Lavinia Machado Boman, Gunnemar Stålenheim

[16] Welcome to Elgg

[17] Sabatine, [edited by] Marc S. (2014). Pocket medicine (Fifth edition. ed.). [S.l.]: Aspen Publishers, Inc. ISBN 1451193785.

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案内

hemoptysis