Clinico-radiological and pathological profile of patients of hemoptysis admitted in a tertiary care centre in Nepal

Abstract

Introduction: Hemoptysis is a common and alarming symptom in patients visiting outpatient as well as emergency department. It is a non-specific complaint that can occur in different clinical conditions including cardiopulmonary and hematological diseases. The aim of our study is to know the clinico- radiological and pathological profile of patients presenting with hemoptysis. Methods: A prospective observational study was conducted in TUTH from 20th July, 2016 to 10th March, 2017. Patients presenting with hemoptysis were admitted via emergency and OPD were evaluated for the cause of hemoptysis via radiological and clinical clues. HRCT/CECT-chest and Bronchoscopy weredone for selected patients. Results obtained were evaluated. Results: A total of 115 patients were enrolled in this study. Mean age of study population was 50.49+14.07 years and mean amount of hemoptysis was 28.27+14.07 ml. Post TB fibrobronchiectasis was found to be the most common cause of hemoptysis in 29.6%. HRCT/CECT-chest was the most sensitive diagnostic test when employed alone with positive yield of 83.3%. However, it failed to locate three cases of lung cancer. When combining a CT study together with a bronchoscopy, the positive yield increased to 100%. Patients diagnosed with lung carcinoma had significant history of smoking, 88.88% patient with diagnosis of lung carcinoma had history of smoking. Conclusion: Hemoptysis is a common symptom arising from varied clinical conditions. Even small amount of hemoptysis should not be ignored and investigated properly. The combined use of bronchoscopy and CT-chest has the best yield in evaluating hemoptysis. In our clinical context, Post TB fibrobronchiectasis was the most common cause of hemoptysis.