Bronchoscopy is a procedure used to look inside the lungs' airways, called the bronchi and bronchioles. The airways carry air from the trachea, or windpipe, to the lungs.

 

During the procedure, a thin, flexible tube called a bronchoscope is passed through the patient's nose (or sometimes the mouth), down the throat, and into the airways. If the patient has a breathing tube, the bronchoscope can be passed through it to the airways.

 

At the bronchoscope's tip are a light and a mini-camera, so the doctor can see the windpipe and airways. The patient is given medicine to make him or her relaxed and sleepy during the procedure.

 

If there is a lot of bleeding in the lungs or a large object stuck in the throat, a bronchoscope with a rigid tube may be used. The rigid tube, which is passed through the mouth, is wider. This allows the doctor to see inside it more easily, treat bleeding, and remove stuck objects.

 

A rigid bronchoscopy is usually done in a hospital operating room while the patient is under general anesthesia. Anesthesia is used so that the patient will sleep through the procedure and not feel any pain.

 

Overview

Bronchoscopy is usually done to find the cause of a lung problem. Samples of mucus or tissue may be taken from the patient's lungs during the procedure to test in a lab. This sampling and testing is called a biopsy.

 

Bronchoscopy may show a tumor, signs of an infection, excess mucus in the airways, the site of bleeding, or something blocking the airway, like a piece of food.

 

Sometimes bronchoscopy is used to treat lung problems. It may be done to insert a stent in an airway. An airway stent is a small tube that holds the airway open. It is used when a tumor or other condition blocks an airway.

 

In children, the procedure is most often used to remove something blocking the airway. In some cases, it is used to find out what's causing a cough that has lasted for at least a few weeks.

 

Outlook

Bronchoscopy is usually a safe procedure. A person may be hoarse and have a sore throat after the procedure. There is a slight risk of minor bleeding or developing a fever or pneumonia.

 

A rare but more serious risk is a pneumothorax, or collapsed lung. In this condition, air collects in the space around the lungs, which causes them to collapse. This problem is easily treated.

 

Scientists are studying new methods of bronchoscopy, including virtual bronchoscopy. This is a kind of computed tomography (CT) scan. A CT scan uses special X-ray equipment to take clear, detailed pictures of the inside of a person's body. During the scan, the subject lies on a table that slides through the center of a tunnel-shaped X-ray machine. X-ray tubes in the scanner rotate around the subject and take pictures of their lungs.

 

Who needs bronchoscopy?

The most common reason why a doctor may decide to do a bronchoscopy is if a patient has an abnormal chest X-ray or computed tomography (CT) scan. These tests may show a tumor, a collapsed lung, or signs of an infection.

 

A chest X-ray takes a picture of the heart and lungs. A CT scan uses special X-ray equipment to take pictures of the inside of the body.

 

Other reasons for bronchoscopy include if a person is coughing up blood or if they have a cough that has lasted more than a few weeks.

 

The procedure also can be done to remove something that is stuck in an airway (like a piece of food), to place medicine in the lung to treat a lung problem, or to insert a stent in an airway to hold it open when a tumor or other condition causes a blockage.

 

Bronchoscopy also can be used to check for swelling in the upper airways and vocal cords of people who were burned around the throat area or inhaled smoke from a fire.

 

Before bronchoscopy

Bronchoscopy is done in a special clinic or in the hospital. To prepare for the procedure, the doctor should be told by the patient:

 

What medicines he or she is taking, including prescription and over-the-counter medicines. It is helpful if the doctor is given a list of the medicines a patient takes.

About any previous bleeding problems.

About any allergies to medicines or latex.

 

Patients should arrange to be driven home from the clinic or hospital. The medicine that is administered before the procedure make cause drowsiness.

 

Patients should avoid eating or drinking for 4 to 8 hours before the procedure. The right amount of time will be specified by the doctor.

 

During bronchoscopy

The procedure is normally carried out in an exam room at a special clinic or in the hospital. The bronchoscopy itself usually lasts about 30 minutes. But the entire procedure, including preparation and recovery time, takes about 4 hours.

 

Medicine is administered through an intravenous (IV) line in the bloodstream or by mouth to cause sleepiness and relaxation.

 

Liquid medicine is sprayed or squirted into the nose and throat to make them numb. This helps prevent coughing and gagging when the bronchoscope (long, thin tube) is inserted.

 

The bronchoscope is then inserted through the nose or mouth and into the airways. As the tube enters the mouth, it may cause a little gagging. However, once it enters the throat, this feeling will go away.

 

The doctor will look at your vocal cords and airways through the bronchoscope (which has a light and a mini-camera at its tip).

 

He or she may take a sample of lung fluid or tissue for further testing. A chest X-ray may be used to help find the exact area to take the sample.

 

Samples can be taken through these methods:

 

Bronchoalveolar lavage. The doctor passes a small amount of salt water (a saline solution) through the bronchoscope and into part of the lung and then suctions it back out. The fluid picks up cells and bacteria from the airway, which can be study.

Transbronchial lung biopsy. The doctor inserts forceps into the bronchoscope and takes a small sample of tissue from inside the lung.

Transbronchial needle aspiration. The doctor inserts a needle into the bronchoscope and removes cells from the lymph nodes in your lungs. These nodes are small, bean-shaped masses. They trap bacteria and cancer cells and help fight infection.

 

Patients may feel short of breath during bronchoscopy, but enough air is reaching the lungs. A patient's oxygen level is checked and if the level drops, oxygen will be provided.

 

If there is a lot of bleeding in the lungs or a large object stuck in the throat, a bronchoscope with a rigid tube may be used. The rigid tube, which is passed through the mouth, is wider. This allows the doctor to see inside it more easily, treat bleeding, and remove stuck objects.

 

A rigid bronchoscopy is usually done in a hospital operating room while the patient is under general anesthesia. Anesthesia is used so that the patient will sleep through the procedure and not feel any pain.

 

After the procedure is done, the bronchoscope is removed.

 

After bronchoscopy

After bronchoscopy, the patient will need to stay at the clinic or hospital for up to a few hours. If a bronchoscope with a rigid tube is used, there is a longer recovery time. While the patient is at the hospital or clinic:

 

He or she may have a chest X-ray if a sample of tissue was taken from the lung. This test will check for a pneumothorax and bleeding. A pneumothorax is a condition in which air or gas collects in the space around the lungs. This can cause the lung(s) to collapse. The condition is easily treated.

A health care provider will check the patient's breathing and blood pressure.

The patient cannot eat or drink until the numbness in the throat wears off. This takes 1 to 2 hours. After recovery, the patient will need to have someone take them home.

 

If samples of tissue or fluid were taken during the procedure, they'll be tested in a lab. The doctor should be consulted about when the lab results will be received.

 

Recovery and recuperation

Patients will be advised by their doctors about when they can return to their normal activities, such as driving, working, and physical activity. For the first few days, a sore throat, cough, and hoarseness are common. The doctor should be called right away if the patient:

 

Develops a fever

Has chest pain

Has trouble breathing

Coughs up more than a few tablespoons of blood

 

What does bronchoscopy show?

Bronchoscopy may show a tumor, signs of an infection, excess mucus in the airways, the site of bleeding, or something blocking the airway.

 

The doctor will use the procedure results to decide how to treat any lung problems that were found. Other tests may be needed.

 

Risks of bronchoscopy

Bronchoscopy is usually a safe procedure. However, there's small risk for problems. The risks include:

 

A drop in a patient's oxygen level during the procedure. Oxygen will be administered if this happens.

A slight risk of minor bleeding and developing a fever or pneumonia.

 

A rare but more serious side effect is a pneumothorax. A pneumothorax is a condition in which air or gas collects in the space around the lungs. This can cause the lung(s) to collapse.

 

This condition is easily treated and may go away on its own. If it interferes with breathing, a tube may need to be placed in the space around the lungs to remove the air.

 

A chest X-ray may be done after bronchoscopy to check for problems.