Airway obstruction arising from blood clot - Three reports and a review ofthe literature

Airway obstruction due to presence of blood clot occurs in a variety of cli nical settings; however, it is not always preceded by hemoptysis. The impac t on respiratory function may be minimal or result in life-threatening vent ilatory impairment. Three illustrative cases and a comprehensive literature review are presented. The presence of endobronchial blood clot is suggested by the clinical and r adiographic findings of focal airway obstruction. The diagnosis is establis hed by direct endoscopic evaluation. Initial efforts at removal of the airw ay clot, if warranted, involve lavage, suctioning, and forceps extraction t hrough a flexible bronchoscope. If unsuccessful, further management options include rigid bronchoscopy, Fogarty catheter dislodgment of the dot, and t opical thrombolytic agents.