Bronchoscopy (bron-KOS-ko-pee) is a procedure used
to look inside the lungs' airways, called the bronchi and bronchioles. The
airways carry air from the trachea (TRA-ke-ah), or windpipe, to the lungs.
During the procedure, your doctor passes a thin,
flexible tube called a bronchoscope through your nose (or sometimes your
mouth), down your throat, and into the airways. If you have a breathing tube,
the bronchoscope can be passed through it to your airways.
At the bronchoscope's tip are a light and a
mini-camera, so the doctor can see your windpipe and airways. You will be given
medicine to make you relaxed and sleepy during the procedure.
If there's a lot of bleeding in your lungs or a
large object stuck in your throat, your doctor may use a bronchoscope with a
rigid tube. The rigid tube, which is passed through the mouth, is wider. This
allows your 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 you're under general anesthesia. Anesthesia is used so you
will sleep through the procedure and not feel any pain.
Overview
Bronchoscopy is usually done to find the cause of a
lung problem. Your doctor may take samples of mucus or tissue from your lungs
during the procedure to test in a lab.
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's 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's 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. You may be
hoarse and have a sore throat after the procedure. There's a slight risk of
minor bleeding or developing a fever or pneumonia.
A rare but more serious risk is a
pneumothorax
(noo-mo-THOR-aks), 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 your body. During the scan, you lie on a
table that slides through the center of a tunnel-shaped x-ray
machine. X-ray tubes in the scanner rotate around you and take
pictures of your lungs.
Virtual bronchoscopy is still not used
often.
Who Needs Bronchoscopy?
The most common reason why your doctor may decide to
do a bronchoscopy is if you have 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 your body.
Other reasons for bronchoscopy include if you're
coughing up blood or if you have a cough that has lasted more than a few weeks.
The procedure also can be done to remove something
that's 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 (small tube) 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.
In children, the procedure is most often used to
remove something blocking an airway. In some cases, it's used to find out
what's causing a cough that has lasted for at least a few weeks.
What To Expect Before Bronchoscopy
Your doctor will do the bronchoscopy in a special
clinic or in the hospital. To prepare for the procedure, tell your doctor:
What medicines you're taking, including
prescription and over-the-counter medicines. It's helpful to give your doctor a
list of the medicines you take.
About any previous bleeding problems.
About any allergies to medicines or latex.
Arrange for someone to drive you home from the
clinic or hospital. The medicine you'll receive before the procedure will make
you sleepy.
Avoid eating or drinking for 4 to 8 hours before the
procedure. Your doctor will let you know the right amount of time.
What To Expect During Bronchoscopy
Your doctor will do the procedure 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.
Your doctor will give you medicine through an
intravenous (IV) line in your bloodstream or by mouth to make you sleepy and
relaxed.
Your doctor also will squirt or spray a liquid
medicine into your nose and throat to make them numb. This helps prevent
coughing and gagging when the bronchoscope (long, thin tube) is inserted.
Then, your doctor will insert the bronchoscope
through your nose or mouth and into your airways. As the tube enters your
mouth, you may gag a little. Once it enters your throat, that feeling will go
away.
Your doctor will look at your vocal cords and
airways through the bronchoscope (which has a light and a mini-camera at its
tip).
The animation below shows a bronchoscopy procedure.
Click the "start" button to play the animation. Written and spoken explanations
are provided with each frame. Use the buttons in the lower right corner to
pause, restart, or replay the animation, or use the scroll bar below the
buttons to move through the frames.
The animation shows how a doctor
inserts a bronchoscope into a patients nose and passes it down into the
airways. This allows the doctor to look at the inside of the airways.
During the procedure, your doctor 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 (BRON-ko-al-VE-o-lar
la-VAHZH). The doctor passes a small amount of salt water (a saline solution)
through the bronchoscope and into part of your lung and then suctions it back
out. The fluid picks up cells and bacteria from the airway, which your doctor
can 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.
You may feel short of breath during bronchoscopy,
but enough air is getting to your lungs. Your doctor will check your oxygen
level. If the level drops, you'll be given oxygen.
If there's a lot of bleeding in your lungs or a
large object stuck in your throat, your doctor may use a bronchoscope with a
rigid tube. The rigid tube, which is passed through the mouth, is wider. This
allows your 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 you're under general anesthesia. Anesthesia is used so you
will sleep through the procedure and not feel any pain.
After the procedure is done, your doctor will remove
the bronchoscope.
What To Expect After Bronchoscopy
After bronchoscopy, you'll need to stay at the
clinic or hospital for up to a few hours. If your doctor uses a bronchoscope
with a rigid tube, there's a longer recovery time. While you're at the hospital
or clinic:
You may have a chest x ray if your
doctor took a sample of tissue from your 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 your breathing
and blood pressure.
You can't eat or drink until the numbness in your
throat wears off. This takes 1 to 2 hours.
After recovery, you'll need to have someone take you
home. You'll be too sleepy to drive.
If samples of tissue or fluid were taken during the
procedure, they'll be tested in a lab. Ask your doctor when you'll receive the
lab results.
Recovery and Recuperation
Ask your doctor when you can return to your normal
activities, such as driving, working, and physical activity. For the first few
days, you may have a sore throat, cough, and hoarseness. Call your doctor right
away if you:
Develop a fever
Have chest pain
Have trouble breathing
Cough 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 your airway.
Your doctor will use the procedure results to decide
how to treat any lung problems that were found. Other tests may be needed.
What Are the Risks of Bronchoscopy?
Bronchoscopy is usually a safe procedure. However,
there's small risk for problems. The risks include:
A drop in your oxygen level during the procedure.
The doctor will give you oxygen 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.
Key Points
Bronchoscopy is a procedure used to look inside
the lungs' airways.
During this procedure, your doctor inserts a
bronchoscope (a thin, flexible tube) through your nose or mouth, down your
throat, and into your airways. At the tube's tip are a light and a mini-camera,
so the doctor can see your windpipe and airways.
This procedure is usually done to find out the
cause of a lung condition, such as a tumor. Sometimes it's done to treat a lung
problem.
Your doctor may decide to do a bronchoscopy if
you have an abnormal chest x ray or computed tomography (CT) scan.
This is the most common reason for bronchoscopy. Chest x rays and
CT scans can show tumors,
pneumothorax
(collapsed lung), or signs of infection.
Bronchoscopy also can be done to remove something
stuck in the airway or to place medicine in the lung to treat a lung problem.
It 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.
In children, bronchoscopy is used to remove
something blocking the airway. In some cases, it's used to find out what's
causing a cough that has lasted for at least a few weeks.
Bronchoscopy is done in a special clinic or
hospital. Your doctor will give you medicine to numb your nose and throat and
make you sleepy and relaxed. Then, your doctor will insert the bronchoscope and
look at your lungs. He or she may take a sample of lung fluid or tissue for
further testing, or he or she may insert a stent (small tube) to hold the
airway open as part of the procedure.
If there's a lot of bleeding in your lungs or a
large object stuck in your throat, your doctor may use a bronchoscope with a
rigid tube. A rigid bronchoscopy is usually done in a hospital operating room
while you're under general anesthesia. Anesthesia is used so you will sleep
through the procedure and not feel any pain.
The bronchoscopy itself usually takes about 30
minutes. But the entire procedure, including preparation and recovery time,
takes about 4 hours.
Bronchoscopy can 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.
Bronchoscopy is usually a safe procedure.
However, there's a small risk for problems. These problems may include a drop
in your oxygen level during the procedure, minor bleeding, or developing a
fever or pneumonia.
A 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. The condition is easily treated.
For a few days after the procedure, you may be
hoarse and have a sore throat. Call your doctor right away if you have chest
pain, trouble breathing, or cough up more than a few tablespoons of blood.