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Surgery in lungs for TB, lower lobe removed. Frequent cough with blood and phlegm, CT shows blood spots on pancreas. Possible treatment ?

sir a friend of mine underwent a surgery in lungs for tb infection and the lower lobe was removed. this was in 2006. It is seen that in between he gets cough and blood comes out along with flum. this happens once in six or seven days. Previously he had taken medicines for tb in two different spells as in the first spell he did not complete a course. he is having pancreatic stones and a seudosyst in pancreas as diagnosed with a CT scan of the abdomen recently. the pancreas shows blood spots. . Kindly siggest possible treatment.
Asked On : Wed, 12 Sep 2012
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Pulmonologist 's  Response
Thanks for your query.
Look your friend's lower lobe has been removed probably because of lower lobe post-TB bronchiectasis or fibrosis. He recently got the single episodes of haemoptysis again. It may be because of post-TB bronchiectatic changes that may involve other lobes also causing hemoptysis again.
In this acute phase i suggest him to take complete bed rest until this episode is getting over along with oral tranexamic acid thrice daily along with cough suppressant like codein syrup with adequate sedation in the form of benzodiazepins.
When this acute phase will get over i will suggest for a recent evaluation of lung condition by HRCT (high resolution computed tomography scan) scan of thorax to exclude further bronchiectatic or fibrotic changes. Consult a chest physician and take his opinion.
For pancreatic stone and pseudocyst surgery is needed to remove the stone or pseudocyst if the diagnosis is already made because too much persisience of stone can lead to chronic pancreatitis that will cause digestion problem and diabetes. So do consult a surgeon immediately.
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thank you.
Answered: Wed, 12 Sep 2012
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