Role of Fibreoptic Bronchoscopy in Abnormal Chest X-Rays-A Prospective Study

Role of Fibreoptic Bronchoscopy

Abstract

Aim- To study the role of fiberoptic bronchoscopy in abnormal chest x-rays. Design- A prospective study done at Department of Pulmonary medicine, Santhiram Medical college from 2013 june to 2015 march. Materials and methods- Once a presumptive diagnosis was made, a fiberoptic bronchoscopy was done in all these patients. Bronchial washings, endobronchial brushings, biopsy were performed in relevant patients and sent for investigations. Results- Out of 206 bronchoscopies performed,48% were for Non-resolving pneumonias, Structural lung diseases 16.9%,mass lesions included 10.6%,collapse 9.7%,pleural disease 8.2%, mediastinal and hilar disease 3.3%, SPN included 2.9%. In NRP, yield of bronchoscopy was 82.83%. Most common etiology in NRP is bacterial followed by malignancy, tuberculosis, fungal and foreign body. In lung mass patients 70% had diagnostic yield with bronchoscope. In lung collapse patients bronchoscopy was useful in 80 % cases. In patients with structural lung disease, mycobacterium tuberculosis was isolated in 20 % patients and among bacteria most common bacteria were klebsiella, pseudomonas. In patients with pleural disorders, bronchoscopy had diagnostic yield in 17.6 % patients. In mediastinal and hilar disorders, yield of bronchoscopy was 42.8 %. In our study bronchoscopy had only diagnostic yield of 16.6 % in patients with SPN. Conclusion- Fibreoptic bronchoscopy is a high yield procedure in diagnosing lung diseases.It is highly recommended in patients with Nonresolving pneumonias, Lung mass, Lung collapse, Structural lung diseases, Mediastinal and Hilar disorders. Comparatively low yield was abserved in patients with undiagnosed pleural diseases,SPN.