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1. BRONCHIECTASIS
Chandana MS
Roll No.21

2. DEFINITION
It is defined as an irreversible, abnormal
dilation of the cartilage – containing airways
bronchi or bronchioles.
Word Bronchiectasis comes from Greek where,
Bronkhia-Airway
Ektasis-Widening

3. CLASSIFICATION
A.Based on Shape of bronchial dilation.(Reid’s
classification)
1. Tubular(cylindrical)
2. Varicose(Bulbous)
3. Cystic(Saccular)

4. B. Based on Extent of Involvement
1) Diffuse: Characterized by widespread
bronchiectatic changes throughout the lung.
2) Focal: Brochiectatic change restricted to a
localized area of lung.

5. ETIOLOGY
The dilatation of bronchi and bronchioles is
caused by Destruction of the muscle and elastic
tissue of bronchial wall.
CAUSES
CONGENITAL ACQUIRED
• Cystic Fibrosis
• Ciliary Dysfunction syndrome
• Alpha-1 Antitrypsin
Deficiency
CHILDREN
• Primary TB
• Inhaled foreign body
ADULTS
• Pulmonary TB
• Suppurative Pneumonia
• ABPA
• Auto Immune diseases

6. PATHOGENESIS

7. CLINICAL FEATURES
SYMPTOMS
Severe Persistent productive cough.
Sputum-Foul smelling.
Haemoptysis.
Pleuritic Chest Pain.
Infective Exacerbation.
General Debility.
Bronchiectasis Sicca.

8. PHYSICAL FINDINGS
General Examination
Pallor, Fever, Weight loss, Night sweats,
Weakness, Halitosis and Sinusitis.
Pan Digital Clubbing.
Respiratory system.
Nasal polyp and signs of chronic sinusitis
Auscultation:
Reveals Crackles and wheezing.
Bilateral coarse, leathery crepitations.

9. INVESTIGATIONS
BLOOD:
Anemia,Raised ESR,leukocytosis
ABG Studies: Respiratory alkalosis
Sputum Examination: It is collected in conical flask
and allowed to stand.
It forms three layers-Top Mucoid layer
Middle Mucopurulent layer
Bottom Purulent layer

10. Chest Radiograph:
Tram-track opacities or Ring shadow reflecting
thickened and abnormally dilated bronchial
walls.

11. HIGH RESOLUTION CT:
Thickened dilated airways-Tram tracks or Signet
ring sign.
Inspissated secretions.

12. Sinus x ray
Bronchoscopy
Pulmonary function tests
Sweat Electrolytes
Serum Immunoglobulins.
Mucociliary Clearance:
Nasal clearance of saccharin
Electron microscopy
Study of sperms

13. COMPLICATIONS
Haemoptysis
Pneumonia
Lung Abscess
Cor Pulmonale
Septicaemia
Respiratory Failure
Generalized edema

14. TREATMENT
Improvements in secretion clearance and
bronchial hygiene.
Methods used- Chest physiotherapy(Postural
drainage)

15. Antibiotic Therapy
For Eradication of bacteria:
 Pseudomonas-Oral ciprofloxacin 500-750 mg
BD or Ceftazidime Iv for 7 days.
For Suppression
Inhaled antibiotics-Tobramycin, Gentamycin
Anti Inflammatory therapy.
Reversal of airflow obstruction.

16. Surgical Treatment
Indications
 Children or young adults with localized lesions
who fail to respond to medical treatment.
Recurrent Haemoptysis.
Recurrent localized Pneumonia.
Procedure
Excision of bronchiectatic areas

17. Treatment for haemoptysis:
Fiberoptic Bronchoscopy.
Embolization of Bronchial Artery.
Surgical Resection.
Other General Measures.