Bronchoscopy

Bronchoscopy

Diagram showing Bronchoscopy

A test that permits the doctor to see the breathing passages through a lighted tube. with its light and small camera, through your nose or mouth, down your throat into your trachea, or windpipe, and to the bronchi and bronchioles of your lungs. This procedure is used to find the cause of a lung problem. It can detect tumors, signs of infection, excess mucus in the airways, bleeding, or blockages in the lungs. It also can allow your doctor to take samples of mucus or tissue for other laboratory tests, as well as to insert airway stents, or small tubes, to keep your airway open to treat some lung problems.

The procedure is performed using a flexible bronchoscope or a rigid bronchoscope. Flexible bronchoscopy is more common than rigid bronchoscopy, and flexible bronchoscopy usually does not require general anesthesia. Before the procedure, you will be given medicine to relax you. A liquid medicine also will be given to numb your nose and throat. If you have low blood oxygen levels during the procedure, you will be treated with oxygen therapy. If you have a lot of bleeding in your lungs or a large object is stuck in your airway, you may require rigid bronchoscopy in a hospital operating room under general anesthesia.

After the procedure, you will be monitored to make sure you don’t have complications. You may experience a sore throat, cough, or hoarseness that will go away with time. If you had the procedure as an outpatient, you likely will be able to go home after a few hours, but you will need a ride home because of the medicines or anesthesia you received. You will need to follow up with your doctor after the procedure to get your results.

Bronchoscopy is usually safe, but there is a small risk for fever, minor bleeding, or pneumonia. Pneumothorax, or collapsed lung, is a rare but serious side effect that can be treated. Your doctor may do a chest x ray after the procedure to check for lung problems.

Uses

Common reasons to do a bronchoscopy for diagnosis are:

• An imaging test showed abnormal changes of your lung, such as a growth or tumor, changes or scarring of lung tissue, or collapse of one area of the lung.
• To biopsy lymph nodes near lungs.
• coughing up blood.
• To explain shortness of breath or low oxygen levels.
• To see if there is a foreign object in airway.
• cough that has lasted more than 3 months without any clear cause.
• An infection in your lungs and major airways (bronchi) that cannot be diagnosed any other way or need a certain type of diagnosis.
• inhaled a toxic gas or chemical.
• To see if a lung rejection after a lung transplant is occurring.

bronchoscopy to treat a lung or airway problem. For example, it may be done to:

• Remove fluid or mucus plugs from your airways
• Remove a foreign object from your airways
• Widen (dilate) an airway that is blocked or narrowed
• Drain an abscess
• Treat cancer using a number of different techniques
• Wash out an airway

Procedure

A bronchoscope is a device used to see the inside of the airways and lungs. The scope can be flexible or rigid. A flexible scope is almost always used. It is a tube less than one half inch (1 centimeter) wide and about 2 feet (60 centimeters) long. In rare cases, a rigid bronchoscope is used.

• Give medicines through a vein (IV, or intravenously) to help the patient relax. Or, under general anesthesia, especially if a rigid scope is used.
• A numbing drug (anesthetic) will be sprayed in the mouth and throat. If bronchoscopy is done through the nose, numbing jelly will be placed in the nostril the tube goes through.
• The scope is gently inserted. It will likely make the subject cough at first. The coughing will stop as the numbing drug begins to work.
• The health care provider may send saline solution through the tube. This washes the lungs and allows the provider to collect samples of lung cells, fluids, microbes and other materials inside the air sacs. This part of the procedure is called a lavage.
• Sometimes, tiny brushes, needles, or forceps may be passed through the bronchoscope to take very small tissue samples (biopsies) from the lungs.
• the provider can also place a stent in the airway or visualize the lungs with ultrasound during the procedure. A stent is a small tube-like medical device. Ultrasound is a painless imaging method that allows your provider to see inside the body.
• Sometimes ultrasound is used to see the lymph nodes and tissues around the airways.
• At the end of the procedure, the scope is removed.

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