{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T12:05:06Z","timestamp":1784894706504,"version":"3.55.0"},"reference-count":12,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,6,6]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>Pulmonary tuberculosis (TB) is one of the most common infectious diseases prevalent in developing countries and can cause life-threatening haemoptysis. The primary sources of haemoptysis in pulmonary TB are the bronchial and pulmonary arteries; however, non-bronchial systemic arteries, such as the intercostal arteries, can also be potential sources of massive haemoptysis. Cases of life-threatening haemoptysis arising from an intercostal artery pseudoaneurysm in patients with pulmonary TB, however, remain underreported.<\/jats:p>\n                  <jats:p>We hereby describe a case of a middle-aged man who was diagnosed with pulmonary tuberculosis on anti-tubercular therapy and is currently in the continuation phase of treatment presented with recurrent episodes of haemoptysis, where CT thoracic angiography of the chest revealed contrast-filled outpouching into right upper lobe cavitary lesion with multiple prominent subsegmental branches of the pulmonary artery. However, a catheter angiogram also revealed tortuous vessels supplying abnormal parenchyma and a pseudoaneurysm arising from the right third intercostal artery, which was managed subsequently by endovascular embolisation. Intercostal artery pseudoaneurysms are uncommon but a clinically significant cause of haemoptysis in patients with pulmonary tuberculosis. Despite their rarity, these vascular complications carry a high risk of morbidity and mortality if not promptly recognised and managed.<\/jats:p>","DOI":"10.1136\/bcr-2025-266563","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T08:35:34Z","timestamp":1752654934000},"page":"e266563","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Uncommon source of haemoptysis in pulmonary tuberculosis: intercostal artery pseudoaneurysm"],"prefix":"10.1136","volume":"18","author":[{"given":"Nitheesha","family":"Pothula","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine, Nitte (Deemed to be University), KS Hegde Medical Academy (KSHEMA), Mangaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adarsha","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Nitte (Deemed to be University), KS Hegde Medical Academy (KSHEMA), Mangaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9927-8544","authenticated-orcid":false,"given":"Vijay","family":"Kubihal","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nitte (Deemed to be University), KS Hegde Medical Academy (KSHEMA), Mangaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1428-4895","authenticated-orcid":false,"given":"Chandramouli","family":"Mandya Thimmaiah","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Nitte (Deemed to be University), KS Hegde Medical Academy (KSHEMA), Mangaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"2026072404550696000_18.7.e266563.1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.4103\/1817-1737.43062","article-title":"Lessons from patients with hemoptysis attending a chest clinic in India","volume":"4","author":"Prasad","year":"2009","journal-title":"Ann Thorac Med"},{"key":"2026072404550696000_18.7.e266563.2","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/0002-9610(55)90113-6","article-title":"Mechanisms of fatal pulmonary hemorrhage in tuberculosis","volume":"89","author":"Thompson","year":"1955","journal-title":"Am J Surg"},{"key":"2026072404550696000_18.7.e266563.3","first-page":"192","article-title":"Haemoptysis and pulmonary tuberculosis \u2013 an analysis","volume":"12","author":"Paramasivan","year":"1994","journal-title":"Lung India"},{"key":"2026072404550696000_18.7.e266563.4","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/S0022-5223(19)38908-1","article-title":"Massive hemoptysis. Review of 123 cases","volume":"85","author":"Conlan","year":"1983","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026072404550696000_18.7.e266563.5","first-page":"48","article-title":"Massive hemoptysis due to intercostal artery aneurysm in pulmonary tuberculosis","volume":"65","author":"Hern\u00e1ndez-Vel\u00e1squez","year":"2016","journal-title":"Pneumologia"},{"key":"2026072404550696000_18.7.e266563.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmcr.2018.07.006"},{"key":"2026072404550696000_18.7.e266563.7","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00102108"},{"key":"2026072404550696000_18.7.e266563.8","first-page":"385","article-title":"On Haemoptysis, Especially When Fatal, in Its Anatomical and Clinical Aspects","volume":"14","author":"Rasmussen","year":"1868","journal-title":"Edinb Med J"},{"key":"2026072404550696000_18.7.e266563.9","doi-asserted-by":"publisher","DOI":"10.1159\/000274492"},{"key":"2026072404550696000_18.7.e266563.10","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1148\/rg.2021200150","article-title":"CT for Evaluation of Hemoptysis","volume":"41","author":"Marquis","year":"2021","journal-title":"Radiographics"},{"key":"2026072404550696000_18.7.e266563.11","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1007\/s11547-012-0866-y","article-title":"Bronchial and nonbronchial systemic artery embolization in managing haemoptysis: 31 years of experience","volume":"118","author":"Cornalba","year":"2013","journal-title":"Radiol Med"},{"key":"2026072404550696000_18.7.e266563.12","doi-asserted-by":"crossref","first-page":"7786","DOI":"10.1007\/s00330-024-10836-y","article-title":"Bronchial artery embolization using small particles is safe and effective: a single center 12-year experience","volume":"34","author":"Sheehan","year":"2024","journal-title":"Eur Radiol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-266563","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T11:55:12Z","timestamp":1784894112000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-266563"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":12,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7,16]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/bcr-2025-266563"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-266563","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}