A B C D E F G H I J K L M N O P R S T U V W

BRONCHOSCOPY

Why is a Bronchoscopy performed ?

Diagnosis of chest complaints may often be made by examination of the patient, perhaps with the aid of simple tests such as a chest x-ray. At times, however, further information is required and a bronchoscopy is recommended. Inspection of the inside of the windpipes allows the doctor to see abnormalities such as ulceration, blockage, bleeding, etc. It is possible to obtain even more information by taking small samples of material from within the windpipes at the time of bronchoscopy. These are called biopsies. The samples are later analysed in the laboratory. Less frequently, bronchoscopy is used not as an aid to diagnosis but for treating certain problems. If, for example, a foreign object such as a peanut is inhaled, this could be removed by performing a bronchoscopy. Similarly, a patient may be producing much sputum and yet be too tired or weak after an operation to cough it up. In such a situation, the sputum could be removed through a bronchoscope.

Preparations needed for a Bronchoscopy

Increasingly, bronchoscopy does not involve you staying in hospital overnight. For most patients, therefore, only one day off work would be required. If you need to have a general anaesthetic for the procedure, then it is more likely that one or two nights in hospital will be necessary. By the day after bronchoscopy, you should be back to normal.

What Happens during a Bronchoscopy

The bronchoscope itself is either a narrow, flexible, plastic tube, or a slightly larger, rigid, metal instrument. If the flexible tube is being used, it is unlikely that you will be completely put to sleep. An injection at the time of the procedure will make you drowsy. Also the nose and throat will be made numb by the use of creams, sprays or lozenges. The tube is then passed through the nose into the back of the mouth. From there it can be advanced into the main windpipe (trachea). Branching off the trachea are two smaller windpipes (bronchi) which themselves branch many times. The bronchoscope can be further advanced into these. Throughout the procedure, the doctor will be looking into his end of the instrument. By so doing, he can direct the bronchoscope where he wishes, see any abnormalities, and if necessary remove small samples from within the windpipes. If the rigid instrument is used, you will always be put to sleep. A pre-medication is first given, which will make you drowsy and gives you a dry mouth. Once asleep, the bronchoscope is passed into the trachea through the mouth. Again the doctor will be looking through his end of the instrument, inspecting the windpipes. If bronchoscopy is being performed to remove foreign objects, it is much more likely that the rigid instrument will be chosen. Bronchoscopy may take only a few minutes to perform, and will rarely last more than half an hour. Virtually all bronchoscopies are done as day cases.

Possible Complications of a Bronchoscopy

It is unusual for there to be any major complications following bronchoscopy, but you may have a sore throat and a cough. If biopsies have been taken from inside the windpipes, this can result in some blood being coughed up. Finally, loose or crowned teeth may be damaged by the passage of the rigid bronchoscope through the mouth.

After a Bronchoscopy

You will probably recover very quickly from bronchoscopy, even if you have been put to sleep for the procedure. Driving would not be advisable on the same day, but by the following day there should be no restrictions and you should be able to return to work. Some information from the bronchoscopy might be available immediately, in which case the doctor may discuss this with you at the time. If material has been sent to the laboratory, it could be several days before the results are obtained. In this situation, a follow-up visit in a week or two would be arranged.

If a Bronchoscopy is not performed

For most patients, bronchoscopy is a means of making a diagnosis. In certain situations, a diagnosis might perhaps be reached by other methods. In general, however, to omit bronchoscopy when recommended could prevent an accurate diagnosis being made and thus prevent correct treatment being started. For patients who have inhaled a foreign object, failure to remove it would probably result in serious infection and damage to the lung.