Massive pulmonary arteriovenous malformation presenting with tamponading haemothorax

A subsequent contrast-enhanced CT scan of the chest revealed a probable pulmonary arteriovenous malformation (PAVM) in the right lower lobe and a compressing organised haemothorax with significant mediastinal shift (fig 1A). Surgical resection of PAVM is indicated in patients who have intrapleural rupture of PAVM. 2 In our case, combined surgical management of the acute bleed followed by catheter embolisation of the PAVM led to a successful outcome.