• Bronchoscopy, Diagnostic

    Definition

    Bronchoscopy is the visual examination of the air passages leading into the lungs. The exam is done with a bronchoscope, a long, thin tube with a camera on the tip.
    Respiratory Pathway
    Resp pathway with sinus
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    Reasons for Procedure

    Bronchoscopy is most often done for the following reasons:
    • Diagnose a lung disease or infection
    • Examine obstructions and secretions
    • Obtain a tissue sample, called a biopsy
    • Obtain a secretion sample
    • Investigate the source of a persistent cough or blood that is being coughed up
    • Check for a foreign object (eg, gum, nut, or other object) that may have accidentally been inhaled rather than swallowed

    Possible Complications

    Complications are rare, but no procedure is completely free of risk. If you are planning to have a bronchoscopy, your doctor will review a list of possible complications, which may include:
    • Bleeding
    • Collapsed lung
    • Irregular heart rate
    • Infection
    • Sore and swollen throat
    Factors that may increase the risk of complications include:

    What to Expect

    Prior to Procedure

    Your doctor may do some or all of the following:
    • Physical exam
    • X-rays of lungs
    • Blood tests
    • CT scan —a type of x-ray that uses a computer to make pictures of the inside of the body
    Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
    • Anti-inflammatory drugs (eg, aspirin )
    • Blood thinners, like clopidogrel (Plavix) or warfarin (Coumadin)
    Leading up to your procedure:
    • Arrange for a ride to and from the procedure.
    • The night before, eat a light meal. Do not eat or drink anything after midnight.

    Anesthesia

    Local anesthetic will be given to numb the throat. It will also help to prevent coughing and gagging. Sometimes, a bronchoscopy is done under general anesthesia. In this case, you will be asleep.

    Description of the Procedure

    The bronchoscope is a long, thin tube. It will be inserted through the nose or mouth. The scope will be passed down the throat and into the lungs.
    The scope sends an image of the lung tissue to a TV monitor. The doctor may use the images and the scope to remove a small tissue sample. If a foreign body is present, the doctor may be able to remove it through the scope. If a lavage is planned, a water solution may be used to wash an area. The solution is then removed and sent to a lab for examination.

    Immediately After Procedure

    The removed tissue or secretions will be sent to a lab for examination.

    How Long Will It Take?

    Less than 1 hour

    How Much Will It Hurt?

    Anesthesia prevents pain during the procedure. You may feel a tugging sensation when the doctor removes a tissue sample. Expect some soreness in your throat and hoarseness for a few days after the procedure.

    Postoperative Care

    When you return home, do the following to help ensure a smooth recovery:
    • Spit out saliva. Do not try to swallow it while your throat muscles are numb.
    • Do not eat or drink anything while your throat is numb. The numbness will last for about two hours.
    • When you are able to eat, start with sips of water. Progress to solid food when ready.
    • If you had a biopsy, do not cough or clear your throat.
    • A chest x-ray will usually be taken before you go home.
    • Do not drive until the sedative has completely worn off and you are fully awake.
    • If you had to stop medicines before the procedure, ask your doctor when you can start again.
    • Resume your normal diet, unless told otherwise by your doctor.
    • Be sure to follow your doctor's instructions .
    The doctor will usually give you a report after the sedative wears off and you are alert. It may take a couple of days to receive results from a biopsy. It may take up to six weeks for findings from a tuberculosis test. Ask your doctor when to expect your results.
    The doctor will usually give you a report after the sedative wears off and you are alert. It may take a couple of days to receive results from a biopsy. It may take up to six weeks for findings from a tuberculosis test. Ask your doctor when to expect your results.

    Call Your Doctor

    After arriving home, contact your doctor if any of the following occurs:
    • Signs of infection, including fever and chills
    • Cough, shortness of breath, or chest pain
    • Coughing up more than a teaspoon of blood
    • Severe nausea or vomiting
    • Increased or unusual wheezing
    • Pain that you cannot control with the medicines you have been given
    In case of an emergency, call for medical help right away.

    RESOURCES

    American Lung Association http://www.lungusa.org/

    American Thoracic Society http://www.thoracic.org/

    CANADIAN RESOURCES

    Canadian Lung Association http://www.lung.ca/home-accueil%5Fe.php/

    Health Canada http://www.hc-sc.gc.ca/index-eng.php/

    References

    American College of Chest Physicians website. Available at: http://www.chestnet.org/ . Accessed October 14, 2005.

    American Thoracic Society website. Available at: http://www.thoracic.org/ . Accessed October 14, 2005.

    6/2/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

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