In this article, we will discuss about the Diagnosis of Severe or Massive Hemoptysis. So, let’s get started.
1. Blood work such as TLC (total leukocyte count), DLC (differential leukocyte count), Hb estimation, and platelet count can be done in order to rule out the diagnosis of any possible infection or bleeding disorder.
2. Chest x-ray provides valuable information for pulmonary congestion, pneumonia, tuberculosis, lung abscess, lung cancer, pulmonary infarcts, etc. CT scan is used to investigate peripheral lesions which are seen in the x-ray and are inaccessible to bronchoscopy and it also facilitates percutaneous needle biopsy, if indicated.
3. Sputum culture is done in order to rule out possible infection and it can also be examined for malignant cells.
4. Fibreoptic bronchoscopy is useful in localizing the site of bleeding and for visualization of endobronchial lesions. In the case of massive hemoptysis rigid bronchoscopy is more preferable than fibreoptic bronchoscopy for better airway control and efficient suction capabilities.
5. CT pulmonary angiography is indicated in patients with suspected pulmonary embolism.
6. Ventricular Perfusion (V/Q) lung scan is useful in confirming the diagnosis of suspected thromboembolic disease.
Below is the flow chart which demonstrates the Management of Massive Haemoptysis