To the Editors:
Flexible fibreoptic bronchoscopy is a safe procedure with a major complication rate of <1% in most published studies 1. In one retrospective study of >4,000 bronchoscopies, major complications (respiratory failure, pneumothorax and pulmonary haemorrhage of >50 mLs) occurred in 0.5% of procedures and minor complications (laryngospasm, vomiting, bronchospasm, vasovagal syncope and epistaxis) in 0.8% of procedures 2. Herein we report an important, rare complication of bronchoscopy that, once recognised, is treatable by prompt action.
A 49-yr-old female underwent elective flexible bronchoscopy during investigation for suspected Mycobacterium tuberculosis. The oropharynx was sprayed with a topical local anaesthetic and intravenous midazolam was used as a sedative. An Olympus BF-260 bronchoscope (Olympus Medical Systems Corporation, Tokyo, Japan) was introduced via a plastic mouth guard (Olympus Endoscope Mouthpiece, 20 mm×27 mm; Olympus Keymed Ltd, Southend-on-Sea, UK). No endobronchial abnormalities were noted …
