Anales de Medicina Interna
versión impresa ISSN 0212-7199
HARO, M. et al. Computed chest tomography and bronchoscopy utility in patients with hemoptysis: Analysis of 482 cases. An. Med. Interna (Madrid) [online]. 2002, vol.19, n.2, pp.11-21. ISSN 0212-7199.
Objective: We have examined the computed chest tomography (CT) and bronchoscopy utility in diagnosis and accurately identifying the sites of pulmonary bleeding in patients with hemoptysis. Methods: We prospectively reviewed the etiology and the site of bleeding of 482 patients with hemoptysis who had undergone bronchoscopy and CT when we suspected a carcinoma, bronchiectasis or the type of bleeding. We analyzed the age, sex, history of tobacco, bleeding, chest radiography, chest computed tomography and bronchoscopy. Results: 62 years (DS 13.6), 84.4% males, 80% smokers and a volume of bleeding of 42,5 ml/day (DS 89) for 15 days (DS 25). Lung cancer was identified in 43%, bronchiectasis in 20%, chronic obstructive lung disease in 14%, pneumonia 8% and an unknown etiology in only 3%. Bronchoscopy located the site of bleeding in 77% and CT in 83%. When we examine only the lung carcinomas, the chest radiography was normal in 11% and the bronchoscopy was diagnostic in 87%, including 6 cases with a normal CT. Simultaneously chest CT or radiography and bronchoscopy detected all the lung cancers. When the chest radiography was inespecific (32%), CT was diagnostic in 43% and bronchoscopy in 14% (p<0.001) or localized the site of bleeding in 52%with the CT or 23% with the bronchoscopy (<0.001). Conclusions: We concluded that bronchoscopy and CT were useful and complementary in etiologic diagnosis and to localize the site of bleeding in patients with hemoptysis. The bronchoscopy was preferable in patients with a lung cancer and the CT or a radiography and the bronchosopy, all the lung cancers were detected.
Palabras clave : Hemoptysis; Computed chest tomography; Bronchoscopy.