1) Undiagnosed Pneumonia : To Take Bronchoalveolar Lavage(BAL), Brushings And Biopsies From Respected Airway Involved On X-Ray Or Ct-Scan

2) Tuberculosis: To take bronchoalveolar lavage , brushings and/or biopsies from respected airway involved on x-ray or ct scan in patients who have dry cough or sputum examination is inconclusive and to diagnose / rule out drug resistant tuberculosis.

3) Malignancy: To take BAL, biopsies from respected segment of bronchial tree involved on ct scan or pet scan , trnasbronchial needle aspiration (TBNA) if enlarged mediastinal lymph nodes with conventional technique or endobronchial ultrasound (EBUS).

Be sure your doctor knows about any medicines you are taking, including vitamins, herbs, and supplements, as well as if you have allergies to any medicines.

You may be asked to stop taking blood-thinning medicines (including aspirin) or some other medicines for several days before the test. You might also be asked not to eat or drink anything for at least several hours before the procedure.

Bronchoscopy can usually be done as an outpatient procedure (where you don’t need to stay overnight in a hospital).

For this test, you’ll lie on your back on a bed or table, with your head raised up slightly. Your mouth (and possibly your nose) and throat will be sprayed first with a numbing medicine. You may also be given medicine through a vein (IV) to make you feel relaxed. Less often, you might be asleep (under general anesthesia) for the test.

If you are awake, the insertion of the scope might make you cough at first. This will stop as the numbing drug begins to work.

The procedure usually takes about 30 minutes, but it might take longer, depending on what’s being done.

After the procedure, you will be watched closely to make sure you don’t have any complications. If you got a sedative, you might not remember the procedure.

Your mouth and throat will probably be numb for a couple of hours. You won’t be allowed to eat or drink until the numbness wears off. Once the numbness is gone, you may have a sore throat, cough, or hoarseness for the next day or so.

Your doctor or nurse should give you specific instructions on what you can and can’t do in the hours after the test.

If biopsies were done as part of the procedure, the results typically will be available within a few days, although some tests on the biopsy samples might take longer.

There are two main reasons a person might need a bronchoscopy:

Evaluation

Your doctor may opt to perform a bronchoscopy to evaluate symptoms and other indications that something may be wrong with the lungs or airways. Examples include:

• A chronic cough—one that has lasted for more than three months with no obvious cause
• Hemoptysis (coughing up blood)
• Shortness of breath or low oxygen levels
• A suspicion there may be something lodged in your airways
• An imaging test that showed a tumor or growth on a lung, scarring or other changes to the lung tissue, or the collapse of an area of a lung
• Symptoms of infection in the lungs or bronchi that can’t be diagnosed another way or require a special type of evaluation
• Signs of rejection after a lung transplant
• Inhalation of a toxic gas or chemical

A bronchoscopy also can be used to take a biopsy of abnormal lung or airway tissue and to visualize tumors within the lungs that do not extend into the bronchi using a technique known as endobronchial ultrasound (EBUS). In this procedure, a tumor deep in the airways may be visualized with ultrasound and biopsied during a bronchoscopy (an ultrasound-guided needle biopsy).

In addition to techniques designed to look deeper than the airways during a bronchoscopy, there are also several new technologies used to diagnose early lung cancers. These include autofluorescence bronchoscopy, narrowband imagery, and high magnification video bronchoscopy.

Treatment

By providing both access and a direct view of the inside of the airways and lungs, a bronchoscopy can allow a doctor to perform all sorts of treatments, such as:

• Removing fluid or mucus from airways
• Removing a foreign object from airways
• Widening (dilating) an airway that is blocked or narrowed
• Washing out an airway

Bronchoscopy can also be used as part of certain treatments for lung cancer that is in or near the large airways. It might be used to assist with a procedure called brachytherapy, for instance, in which radiation is delivered directly to a tumor through the bronchoscope.

There are two types of bronchoscopy. The most common uses a flexible bronchoscope and requires on local anesthesia and a light sedative. Less often a rigid bronchoscope, which is thicker than a flexible one and typically made of metal, is necessary. In that case, a patient must be under general anesthesia in an operating room.