Patients with prolonged (> 7 days) hemoptysis despite continued conservative therapy were selected for the endoscopic procedure. Proper informed consents were obtained. A total of six patients (4 were male, 2 were female), with an average (±SD) age of 56.1 (± 8.33) yr, were treated with the endoscopic procedure (Table 1).
Each patient was clinically evaluated for the possible site and cause of bleeding, and the approximate amount of blood loss was determined. The baseline investigations, such as percentage hemoglobin, packed cell volume, total and differential leukocyte count, erythrocyte sedimentation rate, prothrombin time, partial thromboplastin time, platelet count, and chest roentgenograms were obtained in all of them. CT scan (thorax) was done in four patients. There was no coagulation problem in any of the patients. Sputum smears for acid-fast bacilli were negative in all the patients on at least three different occasions. Two patients (Table 1), who were diagnosed to have pulmonary tuberculosis from the radiologic appearances, showed good clinical response to antitubercular drugs. One patient with past history of treatment for tuberculosis had multiple patchy areas of fibrosis and bronchiectasis. In the other three patients, the etiologic diagnoses were not clear. Fine needle and/or transbronchial needle aspirations revealed no malignancy on cytological examinations in two patients. The aspiration smears did not reveal any infective agent on Gram and Ziehl-Neelsen staining. The patients, however, responded positively to antibiotics. There was no contraindication to bronchoscopy in any of the patients according to the guidelines of the American Thoracic Society.7