폐동맥가성동맥류는 매우 드문 혈관질환으로 파열될 경우 대량 객혈이 발생할 위험성이 높아 치명적일 수 있다. 저자들은 폐농양 치료 후 발생한 폐동맥가성동맥류의 파열로 대량 객혈이 발생하여 금속색전코일을 이용하여 성공적으로 색전술을 시행하였지만, 호흡부전으로 사망한 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Pulmonary artery pseudoaneurysm (PAP) is a very rare vascular abnormality and is often caused at least in part by infection. While Mycobacterium tuberculosis is a relatively common cause of PAP, it can also result from a lung abscess. Aneurysm rupture resulting in massive hemoptysis is potentially fatal, with death caused by aspiration of blood and consequent asphyxiation. We admitted a 55-year-old man with massive hemoptysis. He had been treated with intravenous antibiotics for three weeks after diagnosing a lung abscess. Contrast-enhanced chest computed tomography revealed a pseudoaneurysm inside the abscess. Diagnostic catheter pulmonary angiography confirmed the diagnosis of pseudoaneurysm of the pulmonary artery. Embolization successfully controlled the airway bleeding. However, the patient died of acute respiratory failure on the seventh hospital day. When hemoptysis is due to sustained inflammation, such as a lung abscess, bleeding from the pulmonary artery should be considered. (Korean J Med 2016;90:341-345)