Role of CT scan chest and fiber optic bronchoscopy in evaluating patients with hemoptysis and normal chest radiograph

Introduction: To study the role of CT scan chest and fiber optic bronchoscopy in evaluating patients with hemoptysis and normal chest radiograph. Materials and Method: 50 patients over the age of 15 years having hemoptysis with normal chest X ray in a government teaching hospital in Andhra Pradesh were taken as study subjects. They were evaluated using FOB and CT thorax. Other investigations were done when necessary. Results: The mean age of the study population was 44.5 ± 13.5 years with age ranging from 20yrs to 80yrs. Of them 28(56%) were males and 22 (44%) females. Out of 50 such patients, a definitive diagnosis could be established in 33 patients (66%) with commonest being tuberculosis (12/50, 24%), followed by acute bronchitis (11/50, 22%), bronchiectasis (7/50, 14%), aspergilloma (2/50, 4%), malignancy (1/50,2%). CT scan is more efficacious in establishing a diagnosis of bronchiectasis than bronchoscopy (P 0.05) in diagnosing PTB in patients with hemoptysis and normal CXR. CT scan solely diagnosed 30% cases with bronchoscopic findings being normal. While FOB solely diagnosed 28% cases with CT features being normal. In 8% cases both modalities established the diagnosis. Conclusions: Overall, there was no statistically significant difference (P > 0.05) between CT scan and bronchoscopy in diagnosing the underlying cause of hemoptysis. Therefore, CT scan and bronchoscopy are equally important and complementary to each other in establishing diagnosis in a patient with hemoptysis and normal chest radiograph. Keywords: Fiber Optic Bronchoscopy; CT-chest; Expectoration; Hemoptysis