Helical CT Scan of the Chest and Fiberoptic Bronchoscopy as Diagnostic Tools in Patients with Hemoptysis Having Apparently Normal Chest X-Ray
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Aim: To elucidate the role of' both fiberoptic bronchoscopy, (FOB) and helical computed tommirapliy, (HCT) in the diagnosis of the cause (s) of hemoptysis in patients with apparently normal chest X-ray (CXR). Patients & Methods: The study included 43 patients, with hemoptysis, who were subjected to through clinical history & examination, plain CXR, routine laboratory investigation, Echocardiography, spirometric Pulmonary Ventilatory Function Tests, HCT of chest and FOB. Results : The cause of hemoptysis was unknown in 14 % of patients, due to pulmonry neoplasm in 9%, TB in 27.9%, bronchiectasis in 23.3%, pulmonary embolism in 2.3%, mitral valve stenosis in 9%, COPD in 9.3% and acute bronchitis in 4.6%. HCT catches the final diagnosis in 75% of those with pulmortry neoplasm, 50% in TB, 100% in bronchiectasis, 100% in pulmonary embolism, 25% of COPD with total diagnostic yield of 48.8%, however, FOB was diagnostic in 75% of pulmonary neoplsm patients, 41.6% of TB cases, 75% of COPD cases with total diagnostic yield of 32.6%. Conclusion: HCT is the primary step in the diagnosis of patients with massive hemoptysis having apparently normal CXR, supplemented inevitably by FOB when needed, whenever the clinical, laboratory, and plain radiologic evaluation can't guide for any of them. Echo cardiography was the gold standard in the diagnosis of MVS and other cardiac diseases.