PMC5894021_01
Chest X-ray: bilateral diffuse opacities
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A chest X-ray revealed massive bilateral diffuse opacities (Figure 1).
CT angiography - arterial phase. (A) axial, (B) coronal. Extravasation of contrast is observed in one of the jejunal loops
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Extravasation of contrast was detected in one of the jejunal loops (Figure 2).
CT angiography: diffuse alveolar haemorrhage.
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On the upper range scans, massive changes in the alveoli, suggestive of diffuse alveolar haemorrhage, were present (due to GPA) (Figure 3).
Arteriography: (A) pre-embolization angiography revealed contrast extravasation, (B) post-embolization angiography, no contrast extravasation was observed.
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Selective arteriography of the superior mesenteric artery (based on CT angiography) revealed intra-intestinal bleeding in the territory of the first branches of the superior mesenteric artery (Figure 4A). Angiographic control confirmed the effectiveness of the procedure (radiation dose 521,9 mGy) (Figure 4B).
A follow-up CT scan showed no opacities.
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A follow-up chest CT scan (CTDI 3,4 mGy) revealed regression of the previously described massive changes in the alveoli, and the patient was discharged (Figure 5).