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Bronchoscopy is an endoscopic technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. An instrument ( bronchoscope ) is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy .
Bronchoalveolar lavage (BAL), also known as bronchoalveolar washing, is a diagnostic method of the lower respiratory system in which a bronchoscope is passed through the mouth or nose into an appropriate airway in the lungs, with a measured amount of fluid introduced and then collected for examination.
However, bronchoscopy is an invasive form of imaging and intervention in comparison to the below diagnostic tools, and requires sedation to perform. [24] X-ray An X-ray uses high-frequency electromagnetic radiation to visualize the human body. In the case of choking, a chest X-ray is obtained to visualize the lungs and upper airway.
Basic human airway anatomy. Objects can enter the trachea and lungs via the mouth or nose. Signs and symptoms of foreign body aspiration vary based on the site of obstruction, the size of the foreign body, and the severity of obstruction. [2] 20% of foreign bodies become lodged in the upper airway, while 80% become lodged in a bronchus. [6]
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Flexible bronchoscopy may be used for extraction when distal access is needed and the operator is experienced in this technique. [23] Potential advantages include avoidance of general anesthesia as well as the ability to reach subsegmental bronchi which are smaller in diameter and further down the respiratory tract than the main bronchi. [ 23 ]
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Bronchoscopy with bronchoalveolar lavage is recommended in possible cases of organizing pneumonia to rule out infection and other causes of alveolar infiltrates. [9] The bronchoalveolar lavage in organizing pneumonia shows a lymphocytic predominant inflammation of the alveoli with increases in neutrophils and eosinophils. [9]