Un sintomo di allarme : l'emottisi

Hemoptysis is a term indicating oral emission of blood coming from respiratory sub-glottic airways, independently from its volume. Blood that enters airspaces can derive from every anatomical site of pulmonary or systemic vascular bed located in contact with components of bronchopulmonary apparatus. All diseases directly or indirectly affecting this apparatus, such as thoracic traumatisms, impairments of hemostasis, severe cardiovascular diseases, can determine blood effusions through different mechanisms, giving rise to hemoptysis. Systemic hypervascolarization characterising areas interested by morbid processes and sustained by bronchial systemic or thoracic extrabronchial vascular bed is by far the most common immediate cause generating hemoptysis, followed, in order of importance, by increased lung capillary pressure (frequent in cardiovascular diseases), increased permeability of alveolo-capillary membrane (characteristic of alveolar hemorrhagic syndrome), and alterations of hemostasis. These mechanisms frequently overlap. Tuberculosis (specially reliquates), bronchopulmonary neoplasms, bronchiectasis, are presently the most frequent causes of hemoptysis. The therapy of such no conditions not only needs treatment of the symptom but also of the causal factors, with the aim of reaching full resolution. The medical therapy , specially in massive recurrent clinical forms, must be integrated with selective embolization of the thoracic systemic vascular bed and/or suitable surgery.