notes by dr Claudio Italiano
It also happens to the practical doctor to come across a patient who says he has emitted blood from his mouth, but who can not report whether he vomited,
regurgitated or emitted blood with a cough and sputum. In fact it is very important to collect an accurate medical history.
Haemoptysis means "sputum
of blood". It's an expulsion of blood coming from the airways which can be such as to endanger the patient's life. Do
not confuse a blood-streaked sputum with hemoptysis, even if the presence of blood expelled from the respiratory tract must be taken into account (cf.
cancer of the lung)! A blood-streaked sputum, however, may also be due to
simple bleeding from the gums, varicose veins of the tongue, from inflammation of the rhinopharynx, from acute laryngitis, or may be related to simple paroxysms of
cough.
The causes of hemoptysis are:
Hemoptysis: sputum of blood contained at the bottom
of a plastic cup,
patient with bronchial carcinoma
Pulmonary tuberculosis
Lung cancer
Bronchiectasis
Echinococcus cyst
Pulmonary infarction
Mitral stenosis
Varices of the bottom of the tongue
Pharyngitis
Reflux esophagitis
Lung abscess
Bronchial angiomas
Bronchial mycosis
The hemoptysis of a certain entity can be preceded by sensation of
retro-sternal heat, metallic taste, that is of the iron contained in the
hemoglobin, difficulty of breathing, which is followed by the emission with
coughing of bright red blood and aerated that does not coagulates, and this
immediately happens in full well-being. Cough fits can be frequent and
accompanied by dyspnoea and anxious.
On the other hand, the emission of blood from the digestive tract is defined as
hematemesis, that is, vomiting of blood, therefore
not with a cough. Such vomit may have a coffee color, such as a laying of
coffee, for transformation into hematine of hemoglobin, for this purpose refer
to other links on this website (see hematemesis
Gastrointestinal hemorrhages ).
Some investigations indicated are:
- chest x-ray (see Chest standard radiography Examples of chest radiographs)
- tc thorax with contrast medium
- fibroscopy
- BAL
- Esophagogastroduodenoscopy
- Research of Koch's bacillus on fresh sputum
- Cytological examination of the sputum
CFR pneumology