[Have the causes of hemoptysis changed? An analysis of 213 patients undergoing fiber bronchoscopic exploration].

For decades the most frequent causes of hemoptysis have been bronchiectasis, tuberculosis and bronchogenic carcinoma. A recent study, however, has shown that the etiology has changed, as the incidence of hemoptysis due to tuberculosis or bronchiectasis has decreased while that due to bronchitis has increased. To determine the causes of hemoptysis in patients who underwent fiberoptic bronchoscopy (FB). We conducted a retrospective analysis of clinical profiles and radiologic and FB findings for 213 patients who came to our hospital with hemoptysis between 1990 and 1994. The site of bleeding was located by FB in 139 (64%) patients and a conclusive diagnosis of the cause of hemoptysis was achieved in 170 (78%) cases. The main causes were chronic bronchitis in 64 (29%) patients, neoplasia in 61 (28%) and bronchiectasis in 22 (10%). Tuberculosis was responsible for hemoptysis in only 7 patients (3%). The incidences of the various causes of hemoptysis requiring FB for diagnosis have changed substantially in recent years. Chronic bronchitis and neoplasia are now the most frequent causes. Tuberculosis has become less important. Bronchiectasis, on the other hand, continues to cause of a significant number of cases of hemoptysis in our area.