Bindu Cheriattil Govindan
BACKGROUND Haemoptysis is a symptom that warrants immediate attention. Chest radiograph is mandatory for patients with haemoptysis and it often shows abnormality, but many a time CXR may appear normal. The diagnosis of the cause of haemoptysis is often difficult, especially in patients presenting with a normal chest x-ray. This study has been performed to evaluate these patients using either computed tomography chest or fiber optic bronchoscopy. MATERIALS AND METHODS A prospective cross-sectional study done at a sanatorium of chest diseases in a tertiary care center where 409 cases of haemoptysis were recruited. Among these, 114 patients had CXR that appeared normal (27 %) and they were further evaluated with FOB and CT chest. CT scan was done in 53 and FOB in 80 patients with haemoptysis. RESULTS The use of CT chest, in patients with normal CXR an additional diagnosis was obtained in 37 patients (69.8%). High proportion of patients had bronchiectasis (n-22, 41.5%); carcinoma lung was diagnosed in 3 patients (11.3%). Among 114 patients with normal CXR, 80 underwent bronchoscopy and 3 cases of carcinoma lung were additionally diagnosed. CONCLUSION Computerized tomography and fiber optic bronchoscopy thus helped in increasing yield in diagnosis in 114 patients who had a normal CXR. Patients in whom diagnosis could not be obtained by conventional methods, CT scan increased yield in diagnosis by 32.5%. And with fiber optic bronchoscopy, carcinoma was diagnosed in another 2.6%.
