Hemoptysis: Causes, Differential diagnosis & Managements
Hemoptysis can be caused by various causes, and can be roughly divided into the causes of the organs and bronchi, the causes of pulmonary parenchyma, vascular diseases, and other diseases. The cause of bronchogenic carcinoma, endobronchial metastatic tumor, and bronchial carcinoid, bronchodilator, bronchodilator, tracheal stenosis, foreign body, and foreign body are the causes of bronchogenic carcinoma, bronchogenic carcinoma, tuberculosis, lung abscess, Wegener's Granulomatosis, and the like. Vascular diseases include arteriovenous malformation, pulmonary embolism, pulmonary venous pressure elevation, and other diseases include pulmonary endometriosis, systemic coagulation disorder, hemorrhage and gastrointestinal bleeding. Among these, respiratory tract infection is the most common cause, and bronchial bronchus is the most common bleeding site. Bronchial artery is the main cause of angiography. Although bronchial artery angiography can confirm this, it is known that about 30% of the cases are idiopathic hemoptysis.
Prior to diagnosing hemoptysis, the patient should be informed of the symptoms of the disease (eg, pain in the throat, need for coughing), occurrence (eg, coughing), nature of the exudate (eg, . If the suspicion of bronchitis is confirmed by chest X-ray, bronchoscopy and HRCT should be performed in addition to bronchoscopy. If bronchoscopy is suspected, both bronchoscopy and HRCT should be performed. Bronchoscopy is the first to be performed to identify bleeding sites and causes. Rigid bronchoscopy is useful for massive hemoptysis, and flexible bronchoscopy (eg, fiberoptic bronchoscopy) has the advantage of being accessible to the lower airways. Angiography can be performed after the bleeding site has been confirmed.
If the patient's hemoptysis causes hematologic limitation or makes breathing difficult, it is referred to as massive hemoptysis and usually means a hemoptysis of 100 to 600 mL / day or more. The most common cause of massive hemoptysis is pulmonary tuberculosis, which may be caused by bronchiectasis, lung abscess, lung cancer, and fungal ball (aspergillosis). If the patient complains of massive hemoptysis, ventilation and circulation should be maintained through airway protection (eg intubation) and decubitus position should be taken so that the hemorrhagic part faces downward to prevent aspiration into the normal lung. You can try an antitussive agent such as. In addition to these conservative treatments, angiography and embolization may be considered if bilateral or multiple bleeding or difficult to operate. If all the treatment is unresponsive, lung resection may be considered.
Prior to diagnosing hemoptysis, the patient should be informed of the symptoms of the disease (eg, pain in the throat, need for coughing), occurrence (eg, coughing), nature of the exudate (eg, . If the suspicion of bronchitis is confirmed by chest X-ray, bronchoscopy and HRCT should be performed in addition to bronchoscopy. If bronchoscopy is suspected, both bronchoscopy and HRCT should be performed. Bronchoscopy is the first to be performed to identify bleeding sites and causes. Rigid bronchoscopy is useful for massive hemoptysis, and flexible bronchoscopy (eg, fiberoptic bronchoscopy) has the advantage of being accessible to the lower airways. Angiography can be performed after the bleeding site has been confirmed.
If the patient's hemoptysis causes hematologic limitation or makes breathing difficult, it is referred to as massive hemoptysis and usually means a hemoptysis of 100 to 600 mL / day or more. The most common cause of massive hemoptysis is pulmonary tuberculosis, which may be caused by bronchiectasis, lung abscess, lung cancer, and fungal ball (aspergillosis). If the patient complains of massive hemoptysis, ventilation and circulation should be maintained through airway protection (eg intubation) and decubitus position should be taken so that the hemorrhagic part faces downward to prevent aspiration into the normal lung. You can try an antitussive agent such as. In addition to these conservative treatments, angiography and embolization may be considered if bilateral or multiple bleeding or difficult to operate. If all the treatment is unresponsive, lung resection may be considered.
