Bronchoscopy, Diagnostic
En Español (Spanish Version)

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

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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 that may have accidentally been inhaled rather than swallowed
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Reaction to anesthesia
  • Bleeding
  • Collapsed lung
  • Irregular heart rate
  • Infection
  • Sore and swollen throat
Smoking increases the risk of complications.

What to Expect
Prior to Procedure
Your doctor may do some or all of the following:

Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Blood thinners
  • Antiplatelets
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 and coughing during the procedure. You may feel a tugging sensation when the doctor removes a tissue sample. You may also experience some breathing difficulty or shortness of breath during the procedure.

Expect some soreness in your throat and hoarseness for a few days after the procedure. Any discomfort after the procedure can be managed with medications.

Postoperative Care
You may have an x-ray before you go home. This is to make sure there are no lung complications, such as bleeding or a pneumothorax. A pneumothorax can lead to a collapsed lung.

Once the numbness in your throat wears off, you may be given sips of water. You may gradually progress to solid food as tolerated.

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.
  • If you had a biopsy, do not cough or clear your throat.
  • Do not drive until the sedative has completely worn off and you are fully awake.
  • If you had to stop medications before the procedure, ask your doctor when you can start again.
  • Be sure to follow your doctor's instructions.
The doctor may give you a report after the sedative wears off and you are alert. It may take a few 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 stridor, which is a noisy sound that is heard when breathing
  • Pain that you cannot control with the medications you have been given
If you think you have an emergency, call for medical help right away.




RESOURCES:
American Lung Association

American Thoracic Society

CANADIAN RESOURCES:
Canadian Lung Association


References:
Explore bronchoscopy. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/bron. Updated February 8, 2012. Accessed September 11, 2013.

Fiberoptic bronchoscopy. American Thoracic Society website. Available at: http://patients.thoracic.org/information-series/en/resources/fiberoptic-bronchoscopy.pdf. Accessed September 11, 2013.

Lung cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated August 29, 2013. Accessed September 11, 2013.

Needle biopsy of the lung. Radiological Society of America Radiology Info website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg=nlungbiop. Updated August 5, 2013. Accessed September 11, 2013.

6/2/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: 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.

Last Reviewed September 2013



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