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Bronchiectasis

Bronchiectasis is the permanent dilation of air passages due to obstruction or infection, with localized cases often caused by foreign bodies or tumors, while diffuse cases are typically linked to infections like tuberculosis. The condition involves a 'vicious cycle' of inflammation and structural damage leading to chronic infection and mucus stasis. Clinical features include a chronic cough with purulent expectoration, and diagnosis is confirmed through imaging and sputum culture, with treatment involving antibiotics, drainage, and possibly surgery for severe cases.

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Sakshi Dadhich
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6 views12 pages

Bronchiectasis

Bronchiectasis is the permanent dilation of air passages due to obstruction or infection, with localized cases often caused by foreign bodies or tumors, while diffuse cases are typically linked to infections like tuberculosis. The condition involves a 'vicious cycle' of inflammation and structural damage leading to chronic infection and mucus stasis. Clinical features include a chronic cough with purulent expectoration, and diagnosis is confirmed through imaging and sputum culture, with treatment involving antibiotics, drainage, and possibly surgery for severe cases.

Uploaded by

Sakshi Dadhich
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Bronchiectasis

Bronchiectasis
• It is defined as the permanent dilation of air
passages proximal to the terminal bronchioles.
• It can be diffused and localized.
Etiology
• In localized bronchiectasis etiology is usually
obstruction to the bronchioles.
• Obstruction due to:-foreign body aspirated or
pressure to the bronchus outside (tumor or lymph
nodes). Sometimes tumor inside the bronchus.
• In diffused bronchiectasis etiology is usually
infection.
• As the bacterial infection like pseudomonas or
tuberculosis or atypical mycobacterium.
Contd..
• Hereditary condition like cystic fibrosis, alpha1
antitryprise kartagener syndrome.
• Cystic fibrosis also called mycovisoidosis. In this the all
secretion of body are very thick.
• Kartagener syndrome associated with dextocardia right
side heart shifts agenesis of frontal sinuse.
• Diffuse bronchiectasis occurs in condition like RA,
sjaogeon syndrome, inflammatory bowel disease.
• Immune complication due to any reason leads to auto
immune disease.
Pathogenesis
• The development of bronchiectasis requires two
factors: an infectious insult and impaired drainage,
obstruction, or a defect in host defense.
• This triggers a host immune response
from neutrophils (elastases), reactive oxygen species,
and inflammatory cytokines that results in progressive
destruction of normal lung architecture. In particular,
the elastic fibers of bronchi are affected.
• The result is permanent abnormal dilation and
destruction of the major bronchi and bronchiole walls.
• The "vicious cycle" theory is the generally
accepted explanation for the pathogenesis of
bronchiectasis. In this model, a predisposed
individual develops an excessive inflammatory
response to pulmonary infection or tissue injury.
• The inflammation that results is partially
responsible for the structural damage to the
airways. The structural abnormalities allow for
the stasis of mucus, which favors continued
chronic infection and the persistence of the
vicious cycle.
Pathologically
• 3 types:-
1. Cylindrical
2. Cystic
3. Varicose
This classification based on finding of
bronchiography.
Clinical features
• Cough with large amount of mucoprulent or
purulent expectoration.
• The long history of cough with expectoration.
• History of hemoptysis.
• O/E:- the patient may have clubbing of finger
and toe nails.
• On examination of chest crepitation or
crackles heared over the affected site.
Investigation
• On X-Ray of the chest:- honey cumb
appearance.
• Diagnosis is confirmed by CT Scan of the
Chest.
• Sputum culture – to identify the organism.
Treatment
• During the episodes of acute infection
antibiotics are required infected organism.
• Postural drainage to drain the secretions.
• Mucolytic agents or expectorates are useful.
• If there is massive hemoptysis which is not
control by simple measure, then surgery may
be done.
complication
• Formation of lung abscess
• Metastatic abscess
• Massive hemoptysis

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