Doctors Aren't Sure How This Even Came Out of a Patient

On Tuesday, The New England Journal of Medicine tweeted the most recent addition to its photo series of the most visually arresting medical anomalies. The image is of a mysterious, branchlike structure that, posted elsewhere, would probably pass for a cherry-red chunk of some underground root system or a piece of bright reef coral. But this is no creature of the deep. It’s a completely intact, six-inch-wide clot of human blood in the exact shape of the right bronchial tree, one of the two key tubular networks that ferry air to and from the lungs. And it was coughed up in one piece.

The clot is beautiful, and it’s also kind of gross. The tweet received a slew of replies from those frightened that the photo showed an actual coughed-up lung, which is about as likely to happen as your brain falling out of your butt. But even the doctors who treated the 36-year-old man who produced the clot aren’t entirely sure how it could have emerged without breaking.

Georg Wieselthaler, a transplant and pulmonary surgeon at the University of California at San Francisco, says the unnamed patient was initially admitted to the intensive-care unit with aggressive end-stage heart failure. Wieselthaler quickly connected the patient’s struggling heart to a pump designed to help maximize blood flow through the body. But this type of ventricular-assist device comes with its own risks. “You have high turbulence inside the pumps, and that can cause clots to form inside,” Wieselthalers says. “So with all these patients, you have to give them anticoagulants to make the blood thinner and prevent clots from forming.”



https://www.theatlantic.com/health/archive/2018/12/bronchial-blood-clot/577480/?utm_source=twitter&utm_term=2018-12-06T23%3A34%3A57&utm_content=edit-promo&utm_medium=social&utm_campaign=the-atlantic