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Vol. 31. Issue 7.
Pages 323-327 (October 1995)
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Vol. 31. Issue 7.
Pages 323-327 (October 1995)
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¿Han variado las causas de hemoptisis? Análisis de 213 pacientes sometidos a exploración fibrobroncoscópica
Have the causes of hemoptysis changed? Analysis of 213 patients by fiberoptic bronchoscopy
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V. Plaza1, J. Serra-Batlles, M. Falcó
Sección de Neumología. Hospital General de Vic. Barcelona
J. Brugués*
* Servicio de Medicina Interna. Hospital General de Vic. Barcelona
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Bronquiectasias, tuberculosis y carcinoma broncogénico fueron durante décadas las causas más frecuentes de hemoptisis. Sin embargo, un reciente estudio ha constatado que estas causas han variado considerablemente, descendiendo la incidencia de tuberculosis y bronquiectasias en favor de la bronquitis.

Deseamos conocer las causas de la hemoptisis de nuestros pacientes que por dicho motivo fueron sometidos a exploración fibrobroncoscópica (FB).

Retrospectivamente se analizaron las características clínicas, radiológicas y fibrobroncoscópicas de 213 pacientes que por hemoptisis, fueron remitidos a nuestro centro durante los años 1990-1994.

Mediante FB se pudo orientar la localización del lugar de sangrado en 139 pacientes (64%). Se consiguió un diagnóstico final concluyente de la causa de la hemoptisis en 170 casos (78%). Sus principales causas fueron: bronquitis crónica 64 pacientes (29%), neoplasia 61 (28%) y bronquiectasias 22 (10%). Sólo en 7 pacientes (3%) la tuberculosis fue la responsable de sus hemoptisis.

La incidencia de las diversas causas de hemoptisis que precisan de la práctica de FB para su diagnóstico, ha variado sustancialmente respecto a las observadas antiguamente. La bronquitis crónica y las neoplasias son en la actualidad sus causas más frecuentes. La tuberculosis ha pasado a ocupar un lugar irrelevante. Sin embargo, y a diferencia con otras áreas geográficas, en nuestro medio las bronquiectasias continúan siendo una de las principales causas de hemoptisis.

Palabras clave:
Hemoptisis
Fibrobroncoscopia
Bronquiectasias
Bronquitis crónica
Tuberculosis
Tomograjia axial computarizada (TAC)

For decades the most frequent causes of hemoptysis have been bronchiectasis, tuberculosis and bronchogenic carcinoma. A recent study, however, has shown that the etiology has changed, as the incidence of hemoptysis due to tuberculosis or bronchiectasis has decreased while that due to bronchitis has increased.

To determine the causes of hemoptysis in patients who underwent fiberoptic bronchoscopy (FB).

We conducted a retrospective analysis of clinical profiles and radiologic and FB findings for 213 patients who carne to our hospital with hemoptysis between 1990 and 1994.

The site of bleeding was located by FB in 139 (64%) patients and a conclusive diagnosis of the cause of hemoptysis was achieved in 170 (78%) cases. The main causes were chronic bronchitis in 64 (29%) patients, neoplasia in 61 (28%) and bronchiectasis in 22 (10%). Tuberculosis was responsible for hemoptysis in only 7 patients (3%).

The incidences of the various causes of hemoptysis requiring FB for diagnosis have changed substantially in recent years. Chronic bronchitis and neoplasia are now the most frequent causes. Tuberculosis has become less important. Bronchiectasis, on the other hand, continues to cause of a significant number of cases of hemoptysis in our area.

Key words:
Hemoptysis
Fiberoptic bronchoscopy
Bronchiectasis
Chronic bronchitis
Tuberculosis
Computerized axial tomography
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Copyright © 1995. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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