# Pulmonary arteriovenous fistula secondary to historic thoracic shrapnel injury: presenting features and interventional approach

## TL;DR

A rare case of a lung blood vessel abnormality caused by old chest injury is successfully treated with a minimally invasive procedure.

## Contribution

Demonstrates a successful endovascular treatment for a chronic pulmonary arteriovenous fistula caused by historical thoracic trauma.

## Key findings

- A 50-year-old man with a history of thoracic shrapnel injury presented with a pulmonary arteriovenous fistula.
- Endovascular intervention using a plug-in-stent technique successfully repaired the fistula.
- Hypoxaemia refractory to oxygen therapy can indicate an intra-pulmonary shunt in the absence of a cardiac shunt.

## Abstract

A chronic pulmonary arteriovenous fistula (PAVF) post penetrating thoracic injury is rare; this case demonstrates the presentation, diagnostic implications and a successful endovascular approach to close it.

We report the case of a rare pulmonary arteriovenous fistula in a 50-year-old man secondary to historic thoracic shrapnel injury. He had a positive bubble study on echocardiography; CT pulmonary angiogram identified a pulmonary arteriovenous fistula. He underwent successful repair with an endovascular approach.

PAVF can result from penetrating chest trauma. An intra-pulmonary shunt should be suspected in the setting of hypoxaemia refractory to oxygen therapy and when there is no evidence of an intra-cardiac shunt. Endovascular intervention can facilitate definitive treatment by employing a plug-in-stent technique.

The online version contains supplementary material available at 10.1186/s42155-024-00494-y.