Illustrate the bronchial artery anatomy and primary mechanisms of injury. Determine the need and optimal imaging modality for the evaluation of hemoptysis in the Emergency Department. Propose a structured report to describe radiological findings.

Hemoptysis is defined as the expectoration of blood originating from thesubglottic respiratory tract. Thisexcludes bleeding from the supraglottic airway, attributable to hematemesis or blood aspirated due to nasopharyngeal injury.Our institution reviewed 45 hemoptysis-related studies on the Emergency Department from 2015 to 2022. The primary emphasis was on identifying life-threatening hemoptysis requiring urgent targeted treatment. To do so, we delved into the bronchial anatomy and the pathophysiological basis of each case to establish an optimal imaging protocol. When describing radiological findings, we advocate for the implementation...

1. Anatomy of bronchial arteriesThe bronchial arteries originate from the systemic circulation, with the descending thoracic aorta being the most frequent location [1-3,6]. Based on their origin and trajectory, they can be classified into three types(Figure 1).[Fig 1]a. Orthotopic bronchial arteries (65%): Those originating from the descending thoracic aorta, at the level of the tracheal carina (T5-T6). Right bronchial artery: In 80% of cases, it originates from a common trunk with the third right intercostal artery, known as the right intercostobronchial trunk. It arises from...

A comprehensive understanding of bronchial anatomy and hemoptysis pathophysiology is crucial for identifying cases requiring urgent imaging. Optimal arterial systemic phase angio-CT stands out as the imaging modality of choice in life-threatening cases. Our structured report aids in addressing hemoptysis for both diagnostic and therapeutic purposes.

J. D. De La Morena Molina: Nothing to disclose Á. Díez Tascón: Nothing to disclose M. L. Parra Gordo: Nothing to disclose S. Ossaba: Nothing to disclose M. Fernandez Velilla Peña: Nothing to disclose T. Hernández Cabrero: Nothing to disclose A. Moultamis: Nothing to disclose Á. Romero Guzman: Nothing to disclose M. Marti De Gracia: Nothing to disclose

Walker CM, Rosado-de-Christenson ML, Martínez-Jiménez S, Kunin JR, Wible BC. Bronchial arteries: Anatomy, function, hypertrophy, and anomalies. Radiographics [Internet]. 2015;35(1):32–49. Available in: http://dx.doi.org/10.1148/rg.351140089 Marquis KM, Raptis CA, Rajput MZ, Steinbrecher KL, Henry TS, Rossi SE, etal. CT for evaluation of hemoptysis. Radiographics [Internet]. 2021;41(3):742–61. Available in: http://dx.doi.org/10.1148/rg.2021200150 Ossaba Vélez S, Díez Tascón A, Parra Gordo ML. El informe radiológico en la enfermedad vascular torácica urgente. Radiologia [Internet]. 2022;64:169–78. Available in: https://www.elsevier.es/es-revista-radiologia-119-articulo-el-informe-radiologico-enfermedad-vascular-S0033833822000480 ACR appropriateness criteria ® 1 hemoptysis American college of radiology ACR appropriateness criteria ®...