Rasmussen Aneurysm: a rare fearful complication of pulmonary tuberculosis

Abstract

<b>Introduction:</b> Rasmussen9s Aneurysm is a very rare complication of pulmonary tuberculosis which is caused by the weakening of the pulmonary artery wall from adjacent cavitary tuberculosis. It can be life-threatening if not treated expeditiously. <b>Aims and objectives:</b> describe manifestations and management of Rasmussen Aneurysm <b>Methods:</b> We report 12 cases of Rasmussen’s aneurysm seen between 2015 and 2023 in three pulmonology departments (2, 3, C) of Abderrahman Mami Hospital in TUNISIA <b>Results:</b> There were 11 males and 1 female. The mean age was 45 years [18 to 68 years]. Eleven were smokers. Hemoptysis was the common presenting symptom. Six patients had massive hemoptysis and needed a blood transfusion. Five presented with acute respiratory failure. Thoracic CT scans allowed the diagnosis in all patients. The mean size of the aneurysm was 8 mm [2–16 mm]. The mean delay between the diagnosis of tuberculosis and Rasmussen aneurysm identification was 10 days. In 6 cases, the two diagnoses were made at the same time. Aneurysm localizations were: the upper left lobe in 5 cases, the left lower lobe in 3 cases, the right lower lobe in 2 cases, the right upper lobe in 1 case, and the right middle lobe in 1 case. Five patients required emergent embolization that was successful in 3 cases. Urgent hemostatic surgery was performed in 2 cases (right bi-lobectomy in one case and left upper lobectomy in one case). One patient died from cataclysmic hemoptysis. After one year, 7 patients had a favorable outcome and 4 patients were lost in follow-up. <b>Conclusion:</b> Although rare, Rasmussen Aneurysm commonly manifests as a life-threatening massive hemoptysis. Timely diagnosis and urgent management are mandatory to improve prognosis.