BACKGROUND Massive hemoptysis is a serious complication in Cystic Fibrosis (CF), occurring commonly in older patients. Bronchial artery embolization (BAE) can be performed to stop the bleeding. BAE is generally safe and effective, but can sometimes lead to serious complications. We report the first case of temporary unilateral diaphragmatic paralysis associated to lung consolidation following BAE in a pediatric CF female patient. This complication worsened the lung function of the patient who underwent lung transplantation after 9 months. CASE PRESENTATION A 14 years old female CF patient followed by the CF center of Florence presented low-grade fever, cough increase and recurrent episodes of major hemorrhages such as to carry out a BAE. Within 24 h the patient started to complain of severe thoracic pain in the right hemithorax, increased dyspnea and fever. A computed tomographic angiography and a dynamic fluoroscopic evaluation revealed the right diaphragmatic paralysis, not present before the procedure. After 4 days the clinical condition and radiological imaging had improved with restored mobility of the right hemidiaphragm. Nine months later, she required mechanical ventilation, and subsequently the initiation of extracorporeal membrane oxygenation (ECMO) for a pulmonary exacerbation with septic shock. Lung transplantation in ECMO was performed with success. CONCLUSION Clinicians should be aware of the possibility of phrenic nerve injury with BAE in pediatric CF patients.

中文翻译：

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伴有囊性纤维化和大咯血的女孩继发于支气管动脉栓塞的单侧暂时性diaphragm肌麻痹：1例病例报告。

背景技术大规模咯血是囊性纤维化（CF）中的一种严重并发症，通常发生在老年患者中。可以进行支气管动脉栓塞术（BAE）以止血。BAE通常是安全有效的，但有时会导致严重的并发症。我们报告了第一例小儿CF女性患者BAE后与肺巩固相关的暂时性单侧diaphragm肌麻痹。该并发症使9个月后进行肺移植的患者的肺功能恶化。病例介绍一名14岁的女性CF患者，随后是佛罗伦萨的CF中心，表现为低烧，咳嗽加重和大出血复发发作，例如进行BAE。在24小时内，患者开始抱怨右半胸严重的胸痛，呼吸困难和发烧加重。电脑断层血管造影和动态荧光检查显示右diaphragm肌麻痹，在手术前没有出现。4天后，右半ia肌的活动性恢复，临床状况和放射影像学得到改善。九个月后，她需要机械通气，随后开始进行体外膜氧合作用（ECMO），以使感染性休克的肺部恶化。在ECMO中成功进行了肺移植。结论临床医生应意识到小儿CF患者BAE引起nerve神经损伤的可能性。4天后，右半ia肌的活动性恢复，临床状况和放射影像学得到改善。九个月后，她需要机械通气，随后开始进行体外膜氧合作用（ECMO），以使感染性休克的肺部恶化。在ECMO中成功进行了肺移植。结论临床医生应意识到小儿CF患者BAE引起nerve神经损伤的可能性。4天后，右半ia肌的活动性恢复，临床状况和放射影像学得到改善。九个月后，她需要机械通气，随后开始进行体外膜氧合作用（ECMO），以使感染性休克的肺部恶化。在ECMO中成功进行了肺移植。结论临床医生应意识到小儿CF患者BAE引起nerve神经损伤的可能性。