Author/Editor		Koren, Igor
Title		Hemoptize pri bolnikih z normalnim rentgenogramom prsnega koša
Translated title		Hemoptysis in patients with normal chest radiograph
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 66, št. 9
Publication year		1997
Volume		str. 465-7
Language		slo
Abstract		Background. The patients with hemoptysis and normal chest radiograph, must underwent fiberoptic bronchoscopy. The choice of diagnostic procedures during bronchoscopy is not generally accepted. Methods. In the retrospective 2 years long survey, we evaluated patients with hemoptysis, normal chest radiography and localized bronchial bleeding. All underwent fiberoptic bronchoscopy with broncho-alveolar lavage for acid-fast bacilli, bronchial brushing for cytological examination and finally bronchography of involved bronchus was done. Results. There were 131 patients with hemoptysis and normal chest radiograph, and between them 21 (16%) patients accompanied with localized segmental bleeding. There were mostly men with average age about 60 years. We proved 3 bronchial carcinomas, 1 results was suspicious for carcinoma, none of the broncho-alveolar lavages was positive for Mycobacterium tuberculosis and none of bronchography revealed bronchiectasiae. Conclusions. Normal chest radiograph in patients with hemoptysis, smokers and older than 40 years dosen't exclude the need for bronchoscopy. The incidence of bronchial carcinoma is most likely. Also endobronchial tuberculosis is possible. The bronchiectasiae rarely accompany normal chest radiograph.
Summary		Izhodišča. Pri bolnikih s krvnim izkašljevanjem in sumom, da krvavitev izhaja iz pljuč, v diagnostičnem postopku opravimo predvsem bronhoskopijo z upogljivim inštrumentom. Natančen vrstni red in izbira diagnostičnih postopkov med bronhoskopijo pri bolnikih s hemoptizami in normalno rentgensko sliko pljuč ni vsesplošno sprejet. Metode. V retrospektivnem pregledu smo v obdobju 2 let zajeli bolnike s hemoptizami, normalno rentgensko sliko pljuč in lokalizirano bronhialno krvavitvijo. Med bronhoskopijo so odvzeli bronho-alveolarni izpirek prizadetega bronha na kislino odporne bakterije, krtačili krvaveči bronh za citološki pregled in na koncu opravili še selektivno bronhografijo. Rezultati. Od 131 bolnikov s hemoptizami in normalno rentgensko sliko pljuč je imelo bronhoskopsko lokalizirano krvavitev 21 bolnikov (16%). Večina je bila moških s povprečno starostjo okoli 60 let. Pri 3 bolnikih smo dokazali bronhialni karcinom, pri 1 sum na malignom pri nobenem pa nismo bakteriološko potrdili tuberkuloze oz. bronhografsko morebitnih bronhiektazij. Zaključki. Kljub normalni rentgenski sliki pljuč in srca moramo pri bolnikih s hemoptizami, kadilcih ali bivših kadilcih, starejših od 40 let, obvezno opraviti še bronhoskopijo. Od specifičnih diagnoz je po incidenci na prvem mestu bronhialni karcinom. Tudi endobronhialna tuberkuloza ni izključena. Pri hemoptizah in normalni rentgenski sliki pljuč so bronhiektazije malo verjetne.
Descriptors		HEMOPTYSIS BRONCHOSCOPY BRONCHOGRAPHY BRONCHOALVEOLAR LAVAGE THORACIC RADIOGRAPHY LUNG DISEASES