Rasmussen’s Aneurysm – An Uncommon Fatal Complication of Pulmonary Tuberculosis – Role of MDCT.

Abstract

The incidence of pulmonary tuberculosis is high in developing countries. It can present with minor haemoptysis which is usually self-limiting and controlled with anti-tubercular therapy. Life threatening haemoptysis in pulmonary tuberculosis, which needs urgent intervention is usually arterial in origin. Rasmussen’s aneurysm is an inflammatory pseudo aneurysmal dilatation of a subdivision of pulmonary artery adjacent to a tuberculous cavity. It is an extremely uncommon cause of haemoptysis in pulmonary tuberculosis. The usual site of haemorrhage is from a hypertrophied bronchial artery. Its association with a tuberculous cavity is about 5 %. Its rupture can cause massive haemoptysis and death. We present a case of 44 year old male patient, known case of pulmonary tuberculosis presenting with massive haemoptysis. Contrast enhanced CT thorax showed focal contrast enhancement within the cavity suggestive of aneurysm. This case highlights significance of swift recognition of Rasmussen’s aneurysm in a patient of pulmonary tuberculosis presenting with massive haemoptysis.