Hemoptysis is coughing up blood or blood-stained mucus from the bronchi, larynx, trachea, or lung. This can happen with lung cancer, infections such as tuberculosis, bronchitis, or pneumonia, and certain cardiovascular conditions. Haemoptysis is considered massive at 300 mL (11 Â ° impact, 10 Â ° US fl oz). In such cases, there is always a severe injury. The main danger comes from choking, not blood loss.
Video Hemoptysis
Cause
Maps Hemoptysis
Diagnosis
- Past history, current medical history, family history
- history of tuberculosis, bronchiectasis, chronic bronchitis, mitral stenosis, etc.
- smoking history, occupational diseases with exposure to silica dust, etc.
- Blood
- duration, frequency, number
- The amount of blood: large amounts of blood, or whether there is bloody sputum
- Possible sources of bleeding: Does the blood cough, or vomit?
- The blood sputum
- color, character: bloody, fresh blood, frothy pink, gelatine-bleeding.
- Accompany the symptoms
- fever, chest pain, cough, purulent sputum, mucocutaneous bleeding, jaundice.
- Imaging checks
- chest x-ray, CT scan and 3D reconstruction or CT virtual bronchoscopy, bronchial angiography.
- Laboratory test
- blood test: WBC
- Sputum: cell and bacterial examination, sputum culture
- Bronchial fiber endoscopy
Differential diagnosis
Conditions that usually involve haemoptysis include bronchitis and pneumonia, lung cancer and tuberculosis. Other possible causes include including aspergilloma, bronchiectasis, coccidioidomycosis, pulmonary embolism, pneumonia outbreak, and cystic fibrosis. Less common causes include hereditary hemorrhagic telangiectasia (HHT or Rendu-Osler-Weber syndrome), Goodpasture syndrome, and granulomatosis with polyangiitis. In children, haemoptysis is commonly caused by the presence of foreign bodies in the airways. This condition can also occur due to over-anticoagulants from medications such as warfarin.
Bloody mucus from the sinus or nasal area can sometimes be misidentified as a symptom of haemoptysis (such secretion may be a sign of nasal or sinus cancer, but also a sinus infection). A large non-respiratory injury can also cause a person to cough up blood. Causes of the heart such as congestive heart failure and mitral stenosis should be ruled out.
The origin of blood can be identified by observing its color. The bright red fumes of blood come from the respiratory tract, whereas dark red blood comes from the gastrointestinal tract. Sometimes hemoptysis can be rust colored.
The most common cause of minor haemoptysis is bronchitis.
- Lung cancer, including non-small cell lung carcinoma and small cell lung carcinoma.
- Sarcoidosis
- Aspergilloma
- Tuberculosis
- Histoplasmosis
- Pneumonia
- Pulmonary edema
- Pulmonary embolism
- Aspiration of foreign body and aspiration pneumonia
- Goodpasture Syndrome
- Granulomatosis with polyangiitis
- Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)
- Bronchitis
- Bronchiectasis
- Pulmonary embolism
- Anticoagulant Usage
- Trauma
- Lung abscess
- Mitral stenosis
- Tropical Eosinophilia
- Bleeding disorders
- Hughes-Stovin syndrome and other variants of BehÃÆ'§et disease
- Carcinoma of the esophageal squamous cell
- ANCA-associated vasculitis
Treatment
Treatment depends on the underlying cause. Treatments include saline ice, and topical vasoconstrictors such as adrenaline or vasopressin. Selective bronchial intubation can be used to break down the bloody lungs. Also, endobronchial tamponade may be used. Laser photocoagulation can be used to stop bleeding during bronchoscopy. Bronchial artery angiography can be performed to find bleeding, and can often be isolated. The choice of surgery is usually the last resort, and may involve, removal of the lung or lung removal of the entire lung. Non-small cell lung cancer can also be treated with erlotinib or gefitinib. Cough suppressants may increase the risk of choking.
References
Source of the article : Wikipedia
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