What Is Bronchoscopy?

Bronchoscopy is a medical procedure used to view the inside of your airways and diagnose lung disease. Typically, a pulmonologist (lung specialist) will perform this test to help him or her diagnose your lung condition, particularly if a sample from the lung is needed. Such conditions or problems include: pneumonia, cancer, Tuberculosis, Sarcoidosis, atelectasis (airway collapse), hemoptysis (coughing up blood), foreign body in the lungs, pulmonary fibrosis (lung scarring), or severe and persistant cough.

The instrument, a bronchoscope, can be rigid or flexible. Nowadays, doctors usually use the flexible kind. The flexible tube is about 3/8 inch wide and 2 feet long, with a bright

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light at the end. It has a fiberoptic system that allows the doctor to look at your lungs through an eye piece or camera. There is a small channel in the bronchoscope for suctioning or instrumentation. The bronchoscope is passed through your nose or mouth, vocal cords (voice box), trachea (windpipe), and into your lungs.

Usually, you will be awake but sedated for the procedure. If so, your doctor will numb your nose (or mouth) and throat with a topical anesthetic. This procedure might be done in a endoscopy suite or the operating room. Sometimes, your doctor might request a general anesthetic (completely asleep).

Once the doctor passes the bronchoscope into the lungs, he/she can look inside the major airways and through several branches in each lung. The doctor might inject some saline (salty solution) to wash out a portion of the lung or to help collect samples without taking a biopsy (this is called bronchial lavage). Sometimes brushes, needles, or forceps can be inserted through the channel in the bronchoscope to take tissue specimens from the lung. A bronchoscopy biopsy removes a very small piece of the lung to examine under the microscope. On rare occasions, the doctor might use a laser inside your lung or place a stent into a blocked airway.

Some people having this procedure while awake experience a gagging sensation or urge to cough. You are still able to breath with the tube in place and there is no risk of suffocation. Often with sedation there is no memory of the procedure. Afterwards, your throat might remain scratchy and you might experience cough (possibly with some blood in the mucus if your doctor took a biopsy).

To prepare for the test, your doctor will usually have you not eat or drink for 8-12 hours beforehand. You might also be asked to stop certain medications, including aspirin, ibuprofen or blood thinners. If the test is being done as an outpatient, you will be able to go home the same day and usually resume all normal activities the next day. Since you might be sleepy afterwards, you will usually need someone to drive you home.

Bronchoscopy is a generally safe and uncomplicated procedure. The main risks are bleeding from a biopsy and infection. There is a very small risk for other complications, including heart arrhythmia, pneumothorax (lung collapse), heart attack, breathing difficulty and low blood oxygen.

Most of the time, your doctor will not be able to tell you the result the same day. The test results will usually be back in 2-3 days. Sometimes cultures for certain infections can take 1-2 months (such as tuberculosis).

References:

Merck.com

American Thoracic Society