Hemoptysis diagnostic study of choice: Difference between revisions
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*** Dieulafoy disease | *** Dieulafoy disease | ||
*** [[Kaposi's sarcoma|Kaposi sarcoma]] | *** [[Kaposi's sarcoma|Kaposi sarcoma]] | ||
==Diagnosis of Mild to Moderate Hemoptysis== | |||
The algorithm is based on the American Family Physician Journal of hemoptysis: Diagnosis and Management <ref>name="pmid16225028">{{cite journal| author=Bidwell JL, Pachner RW| title=Hemoptysis: diagnosis and management. | journal=Am Fam Physician | year= 2005 | volume= 72 | issue= 7 | pages= 1253-60 | pmid=16225028 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16225028 }} </ref> | |||
{{Family tree/start}} | |||
{{familytree | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | | | A01= <u>'''Hemoptysis'''</u>}} | |||
{{familytree | | | | | |,|-|-|-|-|-|-|-|^|-|-|-|-|-|-|.| | | | | | | | | | | |}} | |||
{{familytree | | | | | B01 | | | | | | | | | | | | | B02 | | | | | | | | | | |B01= <u>'''Mild hemoptysis'''</u> <br> ❑ <30 cc in 24 hours <ref> name="pmid12243312">{{cite journal| author=Fidan A, Ozdoğan S, Oruç O, Salepçi B, Ocal Z, Cağlayan B| title=Hemoptysis: a retrospective analysis of 108 cases. | journal=Respir Med | year= 2002 | volume= 96 | issue= 9 | pages= 677-80 | pmid=12243312 | doi= | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12243312 }} </ref> | B02= <u>'''Moderate hemoptysis'''</u> <br> ❑ 30-200 cc in 24 hours <ref> name="pmid12243312">{{cite journal| author=Fidan A, Ozdoğan S, Oruç O, Salepçi B, Ocal Z, Cağlayan B| title=Hemoptysis: a retrospective analysis of 108 cases. | journal=Respir Med | year= 2002 | volume= 96 | issue= 9 | pages= 677-80 | pmid=12243312 | doi= | pmc=|url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12243312 }} </ref> }} | |||
{{familytree | | | | | |!| | | | | | | | | | | | | | |!| | | | | | | | | | | |}} | |||
{{familytree | | | | | C01 | | | | | | | | | | | | | C02 | | | | | | | | | | |C01= [[Chest X-ray]] (CXR) | C02= [[Chest X-ray]] and CT }} | |||
{{familytree | |,|-|-|-|^|-|-|-|.| | | | | | |,|-|-|-|^|-|-|-|.| | | | | | | |}} | |||
{{familytree | D01 | | | | | | D02 | | | | | D03 | | | | | | D04 | | | | | | |D01= Diagnose found | D02= Diagnose unknown | D03= Diagnose found | D04= Diagnose unknown}} | |||
{{familytree | |!| | | | | | | |!| | | | | | |!| | | | | | | |!| | | | | | | |}} | |||
{{familytree | E01 | | | | | | E02 | | | | | E03 | | | | | | E04 | | | | | | |E01= Treat underlying disease | E02= <div style="float: left; text-align: left; height: 10em; width: 12em; padding:1em;"> '''Risk of malignancy'''<ref name="pmid22158327">{{cite journal| author=Parkin DM, Boyd L, Walker LC| title=16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. | journal=Br J Cancer | year= 2011 | volume= 105 Suppl 2 | issue= | pages= S77-81 | pmid=22158327 | doi=10.1038/bjc.2011.489 | pmc=PMC3252065 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22158327 }} </ref><br> | |||
❑ [[Smoking]] <br> | |||
❑ Occupational exposure <br> | |||
❑ Family history <br> | |||
❑ Previous cancer treatment </div> | E03= Treat underlying disease | E04= Bronchoscopy to find diagnosis}} | |||
{{familytree | | | | | |,|-|-|-|^|-|-|-|.| | | | | | |,|-|-|-|^|-|-|-|.| | | |}} | |||
{{familytree | | | | | F01 | | | | | | F02 | | | | | F03 | | | | | | F04 | | | F01= Yes | F02= No | F03= Diagnose found | F04= Diagnose unknown}} | |||
{{familytree | | | | | |!| | | | | | | |!| | | | | | |!| | | | | | | |!| | | |}} | |||
{{familytree | | | | | G01 | | | | | | G02 | | | | | G03 | | | | | | G04 | | | G01= [[CT]] or [[bronchoscopy]] to find diagnosis| G02= Close monitoring | G03= Treat underlying disease | G04= Close monitoring}} | |||
{{familytree | |,|-|-|-|^|-|-|-|.| | | |!| | | | | | | | | | | | | | | | | | |}} | |||
{{familytree | H01 | | | | | | H02 | | H03 | | | | | | | | | | | | | | | | | | H01= Diagnose found | H02= Diagnose unknown | H03= If hemoptysis persist consult with pneumonologist}} | |||
{{familytree | |!| | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | |}} | |||
{{familytree | I01 | | | | | | I02 | | | | | | | | | | | | | | | | | | | | | |I01= Treat underlying Disease | I02= Close monitoring}} | |||
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |}} | |||
{{Family tree/end}} | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 16:06, 27 February 2018
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Hemoptysis diagnostic study of choice On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Diagnostic Study of Choice
Study of choice
- The initial diagnostic study in a patient with hemoptysis is chest x-ray.[1]
- Chest x-ray might show underlying cause. However, it might be normal as well.[2]
- The next step is to perform high resolution CT scan or bronchoscopy.[3]
- HRCT is better in some conditions, such as:[4][5]
- Flexible bronchoscopy is better in some conditions, such as:[6]
- Subtle mucosal abnormalities
- Bronchitis
- Dieulafoy disease
- Kaposi sarcoma
- Subtle mucosal abnormalities
Diagnosis of Mild to Moderate Hemoptysis
The algorithm is based on the American Family Physician Journal of hemoptysis: Diagnosis and Management [7]
| Hemoptysis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mild hemoptysis ❑ <30 cc in 24 hours [8] | Moderate hemoptysis ❑ 30-200 cc in 24 hours [9] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Chest X-ray (CXR) | Chest X-ray and CT | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Diagnose found | Diagnose unknown | Diagnose found | Diagnose unknown | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Treat underlying disease | Treat underlying disease | Bronchoscopy to find diagnosis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Yes | No | Diagnose found | Diagnose unknown | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| CT or bronchoscopy to find diagnosis | Close monitoring | Treat underlying disease | Close monitoring | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Diagnose found | Diagnose unknown | If hemoptysis persist consult with pneumonologist | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Treat underlying Disease | Close monitoring | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ Khalil, A.; Fedida, B.; Parrot, A.; Haddad, S.; Fartoukh, M.; Carette, M.-F. (2015). "Severe hemoptysis: From diagnosis to embolization". Diagnostic and Interventional Imaging. 96 (7–8): 775–788. doi:10.1016/j.diii.2015.06.007. ISSN 2211-5684.
- ↑ Andersen, P. E. (2016). "Imaging and interventional radiological treatment of hemoptysis". Acta Radiologica. 47 (8): 780–792. doi:10.1080/02841850600827577. ISSN 0284-1851.
- ↑ Lee, Myoung Kyu; Kim, Sang-Ha; Yong, Suk Joong; Shin, Kye Chul; Kim, Hyun Sik; Yu, Tae-Sun; Choi, Eun Hee; Lee, Won-Yeon (2015). "Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization". The Clinical Respiratory Journal. 9 (1): 53–64. doi:10.1111/crj.12104. ISSN 1752-6981.
- ↑ Gupta, Mudit; Srivastava, Deep Narayan; Seith, Ashu; Sharma, Sanjay; Thulkar, Sanjay; Gupta, Rashmi (2013). "Clinical Impact of Multidetector Row Computed Tomography Before Bronchial Artery Embolization in Patients With Hemoptysis: A Prospective Study". Canadian Association of Radiologists Journal. 64 (1): 61–73. doi:10.1016/j.carj.2011.08.002. ISSN 0846-5371.
- ↑ Noë, G.D.; Jaffé, S.M.; Molan, M.P. (2011). "CT and CT angiography in massive haemoptysis with emphasis on pre-embolization assessment". Clinical Radiology. 66 (9): 869–875. doi:10.1016/j.crad.2011.03.001. ISSN 0009-9260.
- ↑ Sakr, L.; Dutau, H. (2010). "Massive Hemoptysis: An Update on the Role of Bronchoscopy in Diagnosis and Management". Respiration. 80 (1): 38–58. doi:10.1159/000274492. ISSN 1423-0356.
- ↑ name="pmid16225028">Bidwell JL, Pachner RW (2005). "Hemoptysis: diagnosis and management". Am Fam Physician. 72 (7): 1253–60. PMID 16225028.
- ↑ name="pmid12243312">Fidan A, Ozdoğan S, Oruç O, Salepçi B, Ocal Z, Cağlayan B (2002). "Hemoptysis: a retrospective analysis of 108 cases". Respir Med. 96 (9): 677–80. PMID 12243312.
- ↑ name="pmid12243312">Fidan A, Ozdoğan S, Oruç O, Salepçi B, Ocal Z, Cağlayan B (2002). "Hemoptysis: a retrospective analysis of 108 cases". Respir Med. 96 (9): 677–80. PMID 12243312.
- ↑ Parkin DM, Boyd L, Walker LC (2011). "16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010". Br J Cancer. 105 Suppl 2: S77–81. doi:10.1038/bjc.2011.489. PMC 3252065. PMID 22158327.