Causes of hemoptysis in Aleppo University Hospital

Hemoptysis was defined as bleeding originating from the lower respiratory tract. It is an important and alarming symptom, it often indicates serious disease. Hemoptysis is divided into three groups based on the amount of bleeding: trivial [drops of blood, bloody sputum] - moderate [< 500 mL/24h, 1 to 2 cups] - massive [> 500 mL/24 h, more than 2 cups]. Bronchiectasis, lung cancer, bronchitis, and pneumonia are the leading causes of hemoptysis in the cohort studied. The common diagnostic evaluation usually consists of a plain chest radiograph, a CT of the chest, and a fiberoptic bronchoscopy. A retrospective analysis of 125 patients with hemoptysis. We retrospectively reviewed the records of inpatients with hemoptysis at Aleppo University Hospital, between 2003-2005 the following informations: age, sex, clinical history, the amount of bleeding as determined by the admitting physician, the clinical course, evaluation, and final diagnosis. Of the 125 patients evaluated, 86 [68.8%] were male and 39 [31.2%] were female. The average age was 50 +/- 19.7 years. 80 [64%] patients had a positive smoking history and most of them were male [72/80, 80%]. No diagnosis was reached in 21[16.8%] patients. The common causes of hemoptysis were: bronchitis [16.8%], and pneumonia [16.8%]. COPD [10.4%], and lung cancer [10.4%] Bronchiectasis [8%], active tuberculosis [6.4%]. Heart causes [5.6%], Lung abscess [4%]. Others [4.8%]. 64 [51.2%] patients had mild hemoptysis 43 [34.4%] patients had moderate. 8 [14.4%] patients had massive bleeding. Lung cancer, pneumonia, and bronchitis were associated with mild to moderate amounts of bleeding [92.3%, 81% and 100%, respectively], while bronchiectasis had moderate to severe hemoptysis [80%]. 92[73.6%] had abnormal CXR, 33 [26.4%] had normal CXR. No diagnosis was reached in 10/33 [30.3%] patients with normal CXR. 20/33 [60.6%] patients with normal CXR had mild hemoptysis, 11/33[33.3%] had moderate, and 2 [0.6%] patients had massive bleeding. The investigation of kough bacillus was positive in 8/40[20%]. Chest CT scan was performed in 22/125[17.6%] patients. Chest CT scan had a positive results in 14/22[63.6%] patients. Bronchoscopy was performed in 28/125[22.4%] patients. Bronchoscopy had a positive results in 12/24[42.8%] patients. Bronchoscopy was more important in patients with mild and moderate hemoptysis [41 .67%and50%, respectively] compared with patients with severe hemoptysis [8.33%]. The positive diagnostic yield of bronchoscopy was greater when the chest radiograph was abnormal [8/12, 67.7%]. When both chest CT and bronchoscopy were employed 10/28 patients, the positive results was 50%. Although this study gives a good idea of the etiology of hemoptysis in Aleppo University Hospital, it is limited by its retrospective nature