{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T14:19:32Z","timestamp":1764253172773,"version":"3.46.0"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Hemoptysis is defined as blood\u2010streaked sputum from the lower parts of the respiratory tract. Hemoptysis, even in small amounts, is a frightening and alarm sign for possible underlying conditions such as infections, pulmonary diseases, neoplastic conditions, cardiovascular alterations, vasculitis, traumatic events, hematological derangements, and iatrogenic or drug\u2010induced events. The initial step in the evaluation of hemoptysis is to determine the source of bleeding. Herein, we report an unusual case of massive hemoptysis in a young patient with polysplenia and Pulmonary Artery Hypertension (PAH) in the setting of Eisenmenger syndrome. Chest radiography was suggestive of multiple lung opacities bilaterally. Chest Computed Tomography (CT) revealed a non\u2010heterogeneous mass\u2010like lesion measuring 4\u2009\u00d7\u20095.2\u2009\u00d7\u20095.6\u2009cm in the superior segment of the inferior lobe of the left lung, concerning for an accessory spleen. The patient underwent Video bronchoscopy, which showed tracheomalacia and active bleeding in the left main bronchus. The bleeding was controlled by the Argon Plasma Coagulation (APC) technique. Bronchoalveolar lavage (BAL) was negative for acid\u2010fast bacilli on staining and on culture. After stabilization, the patient was discharged home on medical management for PAH. On two\u2010week follow\u2010up, imaging revealed resolution of the pulmonary mass\u2010like lesion. Our report highlights the importance of bronchoscopy in determining the bleeding source in patients with hemoptysis and managing it via the APC technique.<\/jats:p>","DOI":"10.1002\/ccr3.70313","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T03:26:32Z","timestamp":1742441192000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Massive Hemoptysis in a Patient With Eisenmenger Syndrome, Polysplenia and Transverse Liver"],"prefix":"10.1002","volume":"13","author":[{"given":"Mohsen","family":"Shafiepour","sequence":"first","affiliation":[{"name":"Clinical Research Development Unit Afzalipour Hospital, Kerman University of Medical Sciences  Kerman Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Behnam","family":"Dalfardi","sequence":"additional","affiliation":[{"name":"Advanced Thoracic Research Center, Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Nemati","sequence":"additional","affiliation":[{"name":"Assistant professor of Hematology and Oncology Afzalipour Hospital Research Center\u201a Kerman University of Medical Sciences  Kerman Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sina","family":"Bakhshaei","sequence":"additional","affiliation":[{"name":"Internal Medicine Resident UHS SoCal MEC  Temecula California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8878-8303","authenticated-orcid":false,"given":"Elahenaz","family":"Parsi mood","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences Kerman University of Medical Sciences  Kerman Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1093\/med\/9780199600830.003.0126","volume-title":"Oxford Textbook of Critical Care","author":"Blasi F.","year":"2016"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.55001"},{"issue":"2","key":"e_1_2_13_4_1","first-page":"144","article-title":"Hemoptysis: Evaluation and Management","volume":"105","author":"O'Gurek D.","year":"2022","journal-title":"American Family Physician"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01813\u20102017"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.81a.13145"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030633"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24065850"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac237"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-005-0382-8"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.22146\/aci.29703"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.5152\/dir.2014.13426"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.06.41"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.06.011"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.70313","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T14:16:31Z","timestamp":1764252991000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.70313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1002\/ccr3.70313"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.70313","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"type":"print","value":"2050-0904"},{"type":"electronic","value":"2050-0904"}],"subject":[],"published":{"date-parts":[[2025,3]]},"assertion":[{"value":"2024-10-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70313"}}