In a case that has stunned doctors and commoners alike, a 36-year-old man suffering from chronic heart disease failure, coughed up an intact cast of his right bronchial tree in a severe coughing fit.
The patient was undergoing treatment at the University of California San Francisco (UCSF) Medical Center for a medical history of heart failure and had a pacemaker fitted to him.
The case is documented in the New England Journal of Medicine, where it is narrated that during an extreme bout of coughing, the patient spontaneously expectorated an intact case of the right bronchial tree.
The right bronchial tree consists of three segmental branches in the upper lobe (blue arrows), two segmental branches in the middle lobe (white arrows), and five segmental branches in the lower lobe (black arrows).
A general surgery resident at UCSF told the Daily Mail,
"He slowly bled which filled up the right side of the bronchial tree."
After spending a week coughing up mucus and blood, he died from complications.
The patient was extubated 2 days later and had no further episodes of hemoptysis. One week after extubation, he died from complications of heart failure (volume overload and poor cardiac output) despite placement of the ventricular assist device.
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