The contribution of flexible fiberoptic bronchoscopy in diagnosing of unresolved hemoptysis in children

<bold>Introduction:</bold> Hemoptysis is rare among children. The aim of this study was to reveal the contribution of flexible fiberoptic bronchoscopy (FFB) in children with unresolved hemoptysis. <bold>Method:</bold> From February 2014 to February 2024, a retrospective analysis was conducted on patients who underwent FFB at a tertiary care institution due to the indication of hemoptysis. <bold>Results:</bold> Of the 29 children included in the study, the mean (SD) 11.5±0.73 years at the time of FFB. Hemoptysis was mild to moderate in most children (n=27, 93%). Patients who had severe hemoptysis required transfusion; both had pneumonia. Vascular pathologies (n=8, 28%), Munchausen by proxy syndrome (MBP) (n=7, 24%), infectious pathologies (n=5, 18%),bronchiectasis (n=3, 10%), pulmonary hemosiderosis (n=1, 3%), upper airway malformation (n=1, 3%) and platelet dysfunction (n=1, 3%) were detected in the patients. The etiology of 3 patients could not be determined. Morphological and histochemical findings in favor of <italic>Actinomyces</italic> were detected in the bronchoalveolar lavage fluid pathology of a patient with necrotizing pneumonia. 4 patients with vascular pathology revealed lesions that were not seen on thoracic CT, one of which had tortuous dysplastic artery. In 3 patients, the location of bleeding was determined with FFB and embolization was performed with angiography. On the other hand, bronchoscopy was normal in 37.9% (n=11) of the patients. <bold>Conclusion:</bold> If the bleeding localization or underlying cause of hemoptysis in children cannot be determined, FFB is very valuable despite advanced radiological diagnostic methods. MBP is also an important diagnosis that should be considered in etiology.