Bronchoscopy, Diagnostic

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Definition | Body Parts Involved | Reasons for Procedure | Complications | What to Expect | Outcome | Call Doctor If

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Definition

Visual examination of the lungs and air passages, called bronchial tubes, with a bronchoscope, an instrument with a lighted tip. Bronchoscopy is also used to obtain tissue samples and to wash the tissues with saline (a procedure called lavage), which can help a doctor diagnose cancer or an infection.

Parts of the Body Involved

• Mouth or nose
• Throat
• Bronchial tubes
• Lungs

Reasons for Procedure

Bronchoscopy is done to visualize and diagnose problems inside the lungs. It is most often performed for the following reasons:

• Diagnose a lung disease or congenital deformity
• Examine possible tumors, obstructions, and secretions
• Obtain a tissue sample to test for cancer; this is called a biopsy
• Obtain a culture specimen to determine the cause of a lung infection
• Investigate the source of a persistent cough or blood that is being coughed up
• Check for the presence of a foreign body (gum, nut, or other object that may have accidentally been inhaled rather than swallowed)

Risk Factors for Complications during the Procedure

• Pre-existing heart or lung condition
• Chronic illness
• Advanced age
• Mental dysfunction

What to Expect

Prior to Procedure

Your doctor will likely do some or all of the following:

• Physical exam
• Review of medications – you may need to stop taking some medications before the procedure, these include drugs that increase the risk of bleeding
• 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
• Tests to assess how quickly your blood clots and if you have normal levels of clotting factors in your blood

In the days leading up to your procedure:

• Do not take aspirin or other over-the-counter pain medication during the week before the procedure, unless told otherwise by your doctor
• Arrange for a ride to and from the procedure
• The night before, eat a light meal and do not eat or drink anything after midnight

During Procedure - Take deep breaths and do not talk during the procedure. You'll be given the following:

• IV fluids
• Sedation
• Anesthesia
• Oxygen

Anesthesia - Local anesthetic to numb the throat and prevent coughing and gagging. Sometimes bronchoscopy is performed under a general anesthetic.

Description of the Procedure - The doctor threads a long, thin instrument, called a bronchoscope, through the nose or mouth, down the throat, past the vocal cords, through the bronchial tubes, and into the lungs. One of two different bronchoscopes can be used: fiberoptic or open.

A fiberoptic bronchoscope lights up the area, projects a magnified image of the lung tissue on a screen, and allows the doctor to remove a small tissue sample. If a foreign body is present, the doctor may be able to remove it through the bronchoscope. Saline (salt) solution may be used to wash an area of the bronchial tubes or lungs. The solution is then removed and sent to a lab for examination.

An open bronchoscope is thicker and enables the doctor to remove a larger tissue sample. X-rays may be used to help find a suspicious lesion from which to take a biopsy specimen.

After Procedure - Laboratory examination of removed tissue or of the saline used to wash tissues.

How Long Will It Take? Less than 1 hour

Will It Hurt? Anesthesia prevents pain during the procedure, although it may feel uncomfortable and you may feel a tugging sensation when the doctor removes a tissue sample. Expect some soreness in your neck and hoarseness for a few days after the procedure.

Possible Complications:

• Bleeding at the biopsy site
• Collapsed lung
• Irregular heart rate
• Infection
• Sore and swollen throat
• Chipped teeth, if a ridged bronchoscope is used; however, most doctors now use a flexible fiberoptic instrument

Average Hospital Stay - None

Postoperative Care:

• Spit out saliva; do not try to swallow it while your throat muscles are numb
• Do not eat or drink anything for two hours because your throat muscles will still be numb
• When you are able to eat, start with sips of water and progress to solid food as tolerated
• If you had a biopsy, do not cough or clear your throat
• A chest x-ray usually will be taken prior to discharge
• Do not drive until the sedative has completely worn off and you are fully awake
• Resume medications as instructed by your doctor
• Resume your normal diet, unless told otherwise by your doctor

Outcome

The doctor will usually give you a preliminary report after the sedative wears off and you are alert, however, it may take a couple of days to receive results from a biopsy and up to six weeks for findings from a tuberculosis test.

Call Your Doctor If Any of the Following Occurs

• Signs of infection, including fever and chills
• Cough, shortness of breath, chest pain, or severe nausea or vomiting
• Coughing up more than a teaspoon of blood
• Increased or unusual wheezing

SOURCE:

American College of Chest Physicians

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Last reviewed March 2001 by Medical Review Board