Endgames Spot Diagnosis

Recurrent haemoptysis in a child with advanced cystic fibrosis lung disease

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1142 (Published 26 April 2018) Cite this as: BMJ 2018;361:k1142
  1. Donnchadh Martin O’Sullivan, senior house officer1,
  2. Barry Linnane, director of Paediatric Cystic Fibrosis Programme, paediatric respiratory consultant1 2 3
  1. 1Department of Paediatrics, University Hospital Limerick, Dooradoyle, Limerick, Republic of Ireland
  2. 2Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation and Immunity, University of Limerick, Limerick, Republic of Ireland
  3. 3National Children’s Research Centre, Crumlin, Dublin, Republic of Ireland
  1. Correspondence to D M O’Sullivan dosullivan373{at}gmail.com

A 12 year old boy with cystic fibrosis has advanced lung disease (FEV1 30%-40% predicted) and needs monthly intravenous antibiotics given through an implanted venous access device (visible in the radiograph in fig 1). He has experienced recurrent life threatening haemoptysis, for which he was treated with tranexamic acid and propranolol. His condition has not improved. What further intervention, seen on the radiograph (arrows), has he undergone?

Fig 1

Chest radiography of a child with advanced cystic fibrosis lung disease and an implanted venous …

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