Dthe ethereal medical terminology makes the situation almost bearable: "During an extreme cough attack, the patient spontaneously exposed an intact cast of the right bronchial tree".
I translate it in a nutshell, and suddenly life is a bloody horror movie: a poor patient has recorded a perfect bloody replica of the right side of the lungs.
In a viral-hour tweets, The New England Journal of Medicine published a photo with the 6-inch blood clot on December 3rd. The cast maker, a 36-year-old man admitted to intensive care for heart failure, died a week later due to medical complications.
The NEJM regularly drops of unsafe medical images for the picky, but this blood clot took the breath out of the Internet. In addition to collecting many shocked gifs, the photo has collected 2244 retweets and over 4200 I like the publication of this article.
This gross event happened first
Unfortunately – here's your warning about gross content – this is not at all close to the first time patients coughed (tossed) their lungs. The Twitter user @ chifle12 reported to similar gross artifact expelled from a 6-year-old boy, made of lymphatic fluid. Patients with asthma can also form mucus jets that harden in the airways.
And there's more. Suffered from laryngeal diphtheria, a 34-year-old woman produced a similar cast of her trachea in 1926. More recently, a 25-year-old pregnant woman had another bronchus-shaped blood clot in 2005. In that case, the patient recovered and delivered a healthy baby.
What makes this most recent instance special is its unprecedented material and size. Not only is blood typically less resistant than other body materials that it can reach this coarse shape, but the patient's 6-inch wide sample has emerged perfectly intact. When it was explained, Georg Wieselthaler, MD, a transplant and a pulmonary surgeon at the University of Florida in San Francisco, immediately identified the origin of the massive clot.
"We were amazed," said Wieselthaler L & # 39; Atlantic. Based on the way the clot faithfully traced the patient's airway branches, he and his team quickly identified him as his right bronchial tree. "It's a curiosity you can not imagine – I mean, it's very, very, very rare."
How did this form of gross blood?
Doctors have a couple of ideas to explain this huge medical anomaly.
When the human body is running properly, the bronchial tubes are paths for the oxygen that you breathe and the carbon dioxide that you expel. Like an overturned tree, the network of branches expands into small bronchioles that are closed at the tips from the alveoli, where blood flow carries the red blood cells to collect and release oxygen and carbon dioxide.
In the case of the unfortunate patient, there was much more of the air in his bronchi. When he was admitted to the intensive care unit, the doctors hooked him to a ventricular assist device, called Impella, which helps maintain blood flow. But the turbulence of the world's smallest heart pumps can cause clots, so the doctors neutralized the effect by giving the man an anticoagulant to thin his blood.
The anticoagulant has a price – with thinner blood, the body has difficulty patching up any cracks or fissures that open internally. In this case, the patient's blood moved to his right bronchial tree, leaving it to cough up small lumps for days.
To form the record clot, doctors believe that an infection may have caused the patient greater concentration of a fibrinogen, a protein found in blood plasma that acts as "glue". Gavitt Woodard, MD, a clinical colleague at UCSF, estimates that this protein has provided a new resistance that has kept the clot intact.
"Because he was so big, he was able to generate enough force from an entire right side of his chest to push this out and inside," Woodard said L & # 39; Atlantic.
Although the patient did not eventually recover, at that time, doctors report finding relief.
In the meantime, the incident leaves the Internet reflecting on how the phrase "coughing a lung" can be uncomfortably close to real life.