Diagnostic value of delayed Fiberoptic Bronchoscopy in hemoptysis
Al- Anbar Medical Journal,
2009, Volume 7, Issue 1, Pages 85-93
AbstractA study includes 76 patients of different age groups complaining of hemoptysis male represent 60(79%)of the patients white female represents 16(21%) patients ,age incidence varies from 17 to 75 years the peak age groups is that from 40-59 years old which includes 66%.Most of patients in this study complained from hemoptysis of blood as blood streaks, while most of the patients 67(88%) had abnormal radiological findings.The procedure done under local anesthesia in sitting position, trans-nasal approach is routinely done except few cases where trans-oral route used alternatively.Visualization of trachea-bronchial tree and taking samples for cytological, bacteriological, biochemical and screening for tuberculosis were done.Seventy eight percent of the patients had abnormal bronchoscopical finding ranged from tumor masses to paralyzed vocal cords.The samples showed variable findings from malignant cell to chronic bacterial infections.After collection of the direct and indirect findings we diagnose the causes of hemoptysis in a seventy two patients and this study proved that fiber optic bronchoscope is very important and valuable diagnostic tool in hemoptysis with very high sensitivity rate in cases where direct abnormal findings can visualized. This study showed in spite of that CT-scan and MRI studies are important diagnostic modalities; they will never replace the fiber optic bronchoscope in diagnosing of the causes of hemoptysis. Endoscopy:-Is a procedure used to visualize the internal organs by passing an instrument through a natural or artificial orifice (1).Bronchoscopy:- Endoscopic procedure provides direct access to the tracheo-bronchial tree and plays an essential role in the diagnosis and treatment of patients with chest problems (2). Fiber-optic bronchoscopy: - Are flexible bronchoscopes that composed of fiber optic bundles which provides both illumination and visualization pathways. Small channel with diameter (1-3) mm traverse the fiber optic scope through which suction, cathters, brush and biopsy can be taken for chemical, cytological, bacteriological, viral, protozoal and histopath- -logical examination(3,4,5). Diagnostic indication of bronchoscopes (1, 5, 6, and 7):-1-persistant coughs.2-hemoptysis.3-wheeze or bronchial obstruction.4-abnormal thoracic radiography.5-suspected bronchogenic carcinoma.6-airway obstruction.
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