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A Journal on Diseases of the Respiratory System


Official Journal of the Italian Society of Thoracic Endoscopy
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Minerva Pneumologica 2003 March;42(1):25-30

language: Italian

Role of broncoscopy in the diagnosis and treatment of haemoptysis

Mondello B., Monaco M., Calabrò B., Barone M., Barresi P., Familiari D., Monaco F., De Leo G., Pavia R.


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Aim. Broncoscopy plays a unique role in the diagnosis and treatment of hemoptysis, providing information on the cause and locations where bleeding occurs, and suggestions for an optimal therapeutic treatment. The Authors, reviewing their clinical cases, analyze the origin of hemoptysis and the diagnostic protocol followed.
Methods. From July 1997 to December 2002, 122 patients, 97 men (79%) and 25 women (21%) have undergone have been observed for acute hemoptysis. From an etiologic point of view, the principal causes had been identified as follows: neoplasia in 59 cases (48.3%), 55 malignant tumors of the lung (52 primitives and 3 secondary), a recurring tracheal neo-formation in 2 cases, a bronchial adenoma and a bronchial angioma. Other causes included bronchitis and/or pneumonia, bronchiectasis, coagulation diseases, chest traumas, iatrogenic tracheal laceration (post-intubation) and in 13 cases a cryptogenic hemoptysis (10.6%). The cases of massive hemoptysis were 8 (7%).
Results. Broncoscopy has definitely been decisive in 56 cases (45.9%), through local bronchial instillation of adrenalin solution (1:20 000) and/or tranexamic acid in 50 cases, through laser photocoagulation in 6. It has played a diagnostic and propedeutic role for different solutions (surgery, chemotherapy, radiotherapy) in 63 cases (51.6%). No complication has been observed and the procedure has proved to be effective in keeping quickly massive hemoptysis under control; recurrences did not occur.
Conclusion. Broncoscopy must always be carried out in case of hemoptysis, either to discover the origin or to control the disease, and also for the precious information it provides on the kind of therapeutic methodology to be possibly carried out.

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