Bronchoscopy has been advocated as indicated in any child with acute bleeding or without a clearcut cause for the bleeding. Through bronchoalveolar lavage adequate specimens for hemosiderin stains can be obtained. Bronchoscopy has also a therapeutic potential. It will not always identify bleeding vessel, but it may identify tortous vessels that are possible sources. Embolization of these vessels with gelfoam pieces, metal coils or thrombotic agents can be performed at same time and is usually succesful in stopping bleeding.
Further management is dictated by the etiology of the bleeding.
If bleeding persists in spite of aggresive intervention, lobectomy should be considered. The views and opinions expressed in this page are strictly those of the page author. The contents of this page have not been reviewed or approved by the University of Minnesota.