It is a medical procedure that uses an optical system to be able to see inside the airways .
How the test is performed
A bronchoscope is a device used to look inside the lungs. It can be flexible or rigid. Flexible is a tube less than half an inch in diameter and about two feet long (61 cm) and is the most commonly used. The bronchoscope is passed through the mouth or nose , the windpipe, and then into the lungs . Running it through the nose is a good way to examine the upper respiratory tract. The through-the- mouth method allows the doctor to use a larger bronchoscope. A rigid bronchoscope requires general anesthesia .
If a flexible bronchoscope is used, the person will be awake. The doctor will spray an anesthetic in your mouth and throat , which can cause a cough at first that will go away as it begins to work. When the area feels thick, it is because it is already numb enough. The patient may receive medications through a vein (intravenously) to help relax the patient. If the bronchoscopy is done through the nose, a numbing jelly is placed in one nostril. Once you are anesthetized, a tube will be inserted into your lungs, through which the doctor can introduce a saline solution. This flushes the lungs and allows the doctor to collect samples oflung cells , fluids, and other materials within the alveoli. This part of the procedure is called washing.
Sometimes tiny brushes, needles, or forceps can be inserted through the bronchoscope and used to obtain tissue samples ( biopsies ) from the lungs. The pieces of lung material that are removed are small. The doctor may also place a stent in the airway or view the lungs with ultrasound during a bronchoscopy.
Preparation for the exam
Before performing the bronchoscopy, the patient must be fasting since the night before, without drinking alcohol or smoking. The taking of any medication should be consulted with the doctor. After the performance, and after a few hours of surveillance, the patient can generally go home. It is recommended not to drive or do risky activities. During the days following the bronchoscopy, you may have some cough, and expectorate with the presence of a streak of dark blood that disappears in a few days. In case the sputum has red blood, you should notify the doctor.
How the test will feel
Local anesthesia is used to relax the muscles in the throat. Until the anesthetic begins to work, you may feel the fluid move down the back of your throat and you may need to cough or gag. Once the anesthesia takes effect, the patient may experience mild pressure or pulling sensations as the tube travels through the windpipe. Although many patients feel as if they are going to choke when the tube is in the throat, there is no risk of suffocation. If the patient coughs during the exam, more anesthesia will be applied. After the effect of the anesthesia has worn off, the throat may feel rough for a few days. The cough reflex returns 1 to 2 hours after the test and until then, no eating or drinking will be allowed.
Reasons the test is done
The patient may undergo a bronchoscopy to help the doctor diagnose lung problems. The doctor may inspect the airways or take a sample for biopsy. Common reasons for a bronchoscopy are: lung tumor, lymph node, atelectasis, or other changes seen on an x-ray or other imaging test.
- Suspicious interstitial lung disease.
- Coughing up blood ( hemoptysis ).
- Possible foreign object in the airway.
- Cough that has lasted more than three months without any other explanation.
- Infections in the lungs and bronchi.
- Inhaled chemical or toxic gas.
You may also have a bronchoscopy to treat an airway or lung problem, such as:
- Removing fluid or mucus plugs from the airways
- Remove a foreign object from the airway
- Widening (dilating) an airway that is blocked or narrowed
- Drain an abscess
- Treat cancer using many different techniques
- Flushing an airway (therapeutic lavage)
Normal values
Normal cells and secretions are found, and no foreign substances or obstructions are seen. The ranges of normal values may vary slightly between different laboratories. Talk to your doctor about the meaning of your specific test results.
Meaning of abnormal results
- Granulomas
- Infections caused by bacteria, viruses, fungi, parasites, or tuberculosis.
- aspiration pneumonia
- CMV pneumonia .
- chronic pulmonary coccidioidomycosis.
- cryptococcosis.
- chronic pulmonary histoplasmosis.
- pneumonia with pulmonary abscess.
- pulmonary actinomycosis.
- pulmonary aspergilloma (mycetoma).
- pulmonary aspergillosis (invasive type).
- pulmonary histiocytosis X (eosinophilic granuloma).
- pulmonary nocardiosis .
- pulmonary tuberculosis .
- Inflammation of the lungs related to allergic-type reactions (hypersensitivity pneumonitis).
- Interstitial lung disease.
- Lung cancer or cancer in the area between the lungs.
- Narrowing (stenosis) of the trachea or bronchi.
- Rheumatoid lung disease .
- Sarcoidosis
- Vasculitis
Risks
The main risks of bronchoscopy are:
- Bleeding at the biopsy sites.
- Infection.
There is also a small risk of:
- Arrhythmias
- Breathing difficulties.
- Fever .
- Heart attack .
- Low level of oxygen in the blood.
- Pneumothorax .
- Throat pain.
In rare cases where general anesthesia is used, there is some risk of:
- Muscle pain.
- Change in blood pressure
- Slower heart rate
- Nausea .
- Vomiting
There is a low risk of:
- Heart attack.
When a biopsy is taken, there is a risk of severe bleeding ( hemorrhage ). Some bleeding is common, but the technician or nurse will monitor the amount. There is a considerable risk of drowning if anything, including water, is swallowed before the anesthesia wears off.
Considerations
The gag reflex should reappear after the procedure; however, until this happens, do not eat or drink anything. To check if the gag reflex has returned, place a spoon on the back of the tongue for a few seconds with light pressure. If you are not nauseated, wait 15 minutes and try again. Be sure not to use small or sharp objects to test this reflex.