Combination of bronchoscopic cryoextraction and argon plasma coagulation in treatment of total central airway obstruction caused by giant blood clot formation in massive airway bleeding

摘要

Life threatening event due to central airway obstruction caused by very large blood clot formation with profuse on going bleeding its very challenging to manage. Interventional pulmonologist must aware about this situation which can lead to respiratory failure. There are several choices to treat this unlikely situation, in example flexible bronchoscopy with forceps, bronchial lavage, and suction. We present a case with post-surgical tracheostomy bleeding which caused a giant blood clot formation in a disseminated intravascular coagulation due to severe sepsis in end stage renal disease patient, successfully managed with cryoextraction and argon plasma coagulation. Combinations of two endobronchial approaches can give a quick, safe and cost effective lifesaving treatment.