Interventional Pulmonology
It is a new field with in pulmonary medicine focused on the use of advanced bronchoscopic and pleuroscopic techniques for the diagnosis and treatment of a spectrum of disorders involving Airways and Pleura. Bronchoscopy can be defined as a diagnostic and therapeutic procedure that permits direct visualization of the tracheo bronchial lumen with the help of the bronchoscope, a specialized device.
Bronchoscopy is the most commonly used invasive procedure in pulmonology.
Bronchoscopy permits collection of respiratory secretion from the tracheo bronchial tree as well as tissue samples from the airway mucusa, lung parenchyma and lympnedes and other masses located immediately adjacent to but out side the tracheo bronchial lumen.
Bronchoscopy is also used as a therapeutic tool to treat the airway luminal obstruction caused by various diseases, bleeding from respiratory structures and several pulmonary disorders.
Diagonostic Indications
- Unexplained Cough
- Hemoptysis
- Localised Wheeze (with suggestion of obstruction)
- Stridor
- Unexplained Chest Radiography Opacity.
- Pulmonary infection (when not improving)
- Immuno Compromised
- Diffuse lung diseases Non-infectious
- Intra thoracic Lympthadenopathy
- Pulmonary Neoplasm
- Foreign body
- Burns
- Vocal cord & Diaphragm Palsy
Therapeutic Indications
- Removal of airway secretions, mucus plugs, clots and necrotic debris
- Atelectasis
- Foreign body
- Neoplasms
- Laser
- Electro cautery
- Endobronchial ultrasound
- Argon Plasma Cogulation ( APC)
- Cryotheraphy
- Stenting
- Lavage
Medical Thoracoscopy or pleuroscopy is an invasive technique to visualise the pleural cavity under local anesthesia / conscious sedation.
Indications:
- Pleural effusion of unknown etiology
- Staging of lung cancer
- Staging of diffuse malignant mesothelioma
- Pleurodesis by talc powderage
- Pleuroscopy or medical Thoroscopy helps in draining the pleural fluid and to take Pleural biopsies.
TB is a completely curable disease. It is due to mycobacterium tubercle bacilli causing cough, fever, weight loss etc. The diagnostic tests are sputum test for AFB and chest radiography. Treatment consists of 6-9 months with anti TB therapy.
TB can manifest as hemoptysis (coughing out of blood), Fever of unknown origin, pleural effusion etc., MDR-TB is diagnosed based on the sensitivity of the MTB Bacilli. Asthma is a chronic inflammatory disorder of the airways characterized by recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night or in the early morning. Clinical history and Spirometry (PFT with reversibility testing) is a breathing test to confirm asthma.
