This document provides information about bronchiectasis, including its causes, symptoms, diagnosis, and management. It describes bronchiectasis as an abnormal permanent dilation of the bronchi due to destruction of the bronchial wall muscles and elastic tissue. Common causes include infection, aspiration, obstruction, and genetic conditions like cystic fibrosis. Symptoms include chronic cough, sputum production, and recurrent lung infections. Diagnosis is made through clinical history and characteristic findings on CT scan. Management focuses on controlling infections with antibiotics, clearing secretions, and treating underlying causes.

1. Bronchiectasis
Presented by
Dr. Mohamed Abdelaziz Omer
Consultant chest physician

2. Distributes air to the lungs
Exchange gases ( primary function of the lungs )
Nostrils , mouth , pharynx , larynx , bronchial tree

6. Wind pipe
 Passage way that supplies air to the lungs
 4.5 inches long ……. 1 inch in diameter
 smooth muscle & several C shaped rings of cartilage
which provides stability & help prevent collapse
 Start in the neck , divided into two main branches

7. trachea

8. Bronchi
 Structurally similar to the trachea
 Two primary bronchi inside the lungs
 Rt. Is slightly larger ..minimal angulations…
continuation
 foreign bodies

9. Branching
 Each bronchi divided into 5 smaller secondary bronchi
 2ndry bronchi branched to form tertiary bronchi
 Tertiary bronchi divided into terminal bronchioles (cartilage
less)
 30 000 bronchioles in each lung
 Alveolar ducts, sacs
 Alveoli …. Very thin wall 2cells thick

12. Purifier
 Mucus blanket covers large proportion of the
membrane lining the bronchial tree
 125 ml daily
 Cilia
 Hair like moves the mucus up to the pharynx

13. Broncheictasis
 Uncommon disease 20-50% cause not found ( B L F )
 Most often secondary to an infectious process
 Could be congenital
 described by Laennec 1819
 detailed by sir Wilham Osler in late 1800
 Reid characterized it as cylindrical ,cystic ,varicose in 1950

14. Definition
 Abnormal permanent distortion of one or > conducting bronchi
 Abnormal dilatation of the proximal & medium sized >2mm
 Cylindrical diffuse mucosal edema & dilatation but straight end
abruptly
 Varicose has a bulbous appearance with a dilated bronchus &
interspersed sites of relative constriction & obstructive scarring

20. picture
 Caused by weakness or destruction of the muscular elastic
component of the bronchial wall
 Transmural inflammation , edema , scarring , ulceration

21. causes
 impaired drainage
 aspiration
 Obstruction (middle lobe syndrome )
 Defect of defense mechanism or host response
neutrophilic proteases , cytokines , NO , O2 radicals

22. . CF , William-Capell syndrome
 Mounier-Kuhn (tracheobronchomegally), Swyer-James
Macleod syndrome (unilateral hyper lucent lung) ,
yellow nail syndrome young syndrome , Iry ciliary
dyskinasia , AAT deficiency , AD PKD , Toxic gas exposure
 CTD , autoimmune diseases , idiopathic inflammatory
disease , immune deficiency

23. Bronchiectasis most commonly present as a focal process
involving a lobe , segment or sub-segment of the lung
 Far less commonly it may be a diffuse process involving
entire lung or both lungs these cases most often occur
in association with systemic illness such as CF ,
sinopulmonary disease or both
 Majority of this article will address non-CF related

27. Typical offending organisms
 Necrotizing infection either inadequately or non treated at all
 klebsiella sp. , staph.aureus , MTB , NMTB , Mycoplasma
pneumonia measles , pertussis , HSV , RSV in childhood ,
MAC and certain types of adenoviruses
.Widened airways with extra mucus are prone to infection
.Haemophilus species 50% , pseudomonas 20%

28. Cystic fibrosis
 The most common cause in developed countries
 Multisystem disorder , chloride transport system in
exocrine
 2ry to a defect in CFTR protein
 Autosomal recessive

29. Gregor Mendel

30. Symptoms
 No to few symptoms morphological diagnosis
 Dry variant post TB upper lobes
 Weakness , weight loss
 Cough , sputum ,blood streaks , dyspnea , pleuritic chest pain
wheezing , fever

31. complications
 Recurrent pneumonia , Chronic bronchial infection
 Empyema , abscess
 Core pulmonale
 Pneumothorax
 Life threatening hemoptysis ?
 Respiratory failure

32. Diagnosis
 Compatible clinical Hx. Of chronic respiratory symptoms
 Daily cough & viscid sputum production
 Characteristic radiographic finding on CT scan ( bronchial
wall thickening & luminal dilatation )

33. prognosis
 Pre-antibiotic era die within 5 years
 1940 the mortality was 30% mostly die within 2 years
 1990 in Finland compared the mortality rate :-
20% BA , 28% bronchiectasis , 38% COPD
 Bronchiectasis with CF is of worst prognosis

35. Prevention
 Immunization
 Flu vaccination
 Smoking
 counseling

36. management
 Control infection antibiotics
 Bronchodilators
 Control secretions steroids Postural drainage
 Lobectomy , artery embolization
 oxygen
 Dietary supplementation
 creosote

39. Thank you