Bronchoscopy with lavage (BAL)
Alternative names:
BAL
How the test is performed:
The bronchoscopy is usually done in the hospital. Several blood tests are done before the bronchoscopy. You will be asked to lie on a table or bed. An intravenous (IV) line may be placed in a vein in your arm. A local anesthetic is sprayed into your throat (to numb the throat and stop the gag reflex). The bronchoscope is then inserted through your mouth or nose. When the bronchoscope reaches your vocal cords, an anesthetic is introduced through the scope to numb deeper areas. The bronchoscope is moved down the major airways to examine lower air passages and your lungs. A fluoroscope (a special X-ray that projects the images on a TV monitor to observe what is happening) may be used to help guide the bronchoscope to different sections of your lung. A saline solution may be used to wash some of the passages that the scope can not reach and then suctioned out (this is the "lavage" portion of the test). The washings are sent to the laboratory to be examined.
How to prepare for the test:
The health care provider should know if you have allergies to any medication, which medications are being taken, and if you have a bleeding problem. Also inform the health care provider if you are pregnant or have a loose tooth. You must sign a consent form. You must fast for 6 to 8 hours before the test (this helps prevent vomiting or choking). Smokers are advised not to smoke at least 24-hours before and after the test. You must wear a hospital gown.
Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:
How the test will feel:
The local anesthetic may have an unpleasant taste and may cause you to gag and cough when it is first sprayed in the throat. There may be a feeling of a thick tongue and the inability to swallow (you can actually swallow) or breathe. The bronchoscope will not block breathing. You may have a sore throat, hoarseness, or loss of voice for several days after the test.
Why the test is performed:
The bronchoscopy is used for diagnosis and treatment. It helps locate the cause of blood in the sputum, localized wheezing in the chest, or the cause of difficulty in breathing. It helps evaluate abnormalities that have been seen on X-rays and discover the location and extent of lung cancer.
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