Bronchiectasis is a chronic condition of the lung. It is a permanent dialation of the bronchi or bronchioles in the lungs due to other pathological conditions like cystic fibrosis/ pulmonary tuberculosis etc., . etiology, pathology, clinical features diagnostic crieteria to identify the cause of bronchiectasis, management, and preventive measures. differential diagnosis is key point to finding the actual disease condition of the lung.

1. Dr. K. Malathi
MD Scholar
Department of Kaya Chikitsa.

2. CONTENTS
Definition
Aetiology
Classification/Types
Pathogenesis
Clinical features
Diagnosis
Treatment
Summery

3. Definition
Bronchiectasis is a destructive lung disease characterized by
chronic / perminant dialation of the bronchi associated with
persistent through variable inflammatory process in the
lungs.
 Most of the lower lobes of the lungs
Focal or diffuse distribution

4. Aetiology:
It is often brought by damage of the lungs by other
conditions as:
 Tuberculosis
Cystic fibrosis
Immotile Ciliary Syndrome

5. Alpha 1 antitrypsin deficiency
Autoimmune disorders
Inhaled foreign bodies
Allergic bronchopulmonary aspergillosis ABPA
Post radiation fibrosis
HIV

6. Classification
 Cylindrical – The luminal dialation is same
 Saccular / Cystic – loss of
bronchial subdivision
 Varicose – irregular appearance

7. Cylindrical /Tubular/Fusiform Bronchiectasis -
bronchi retain their regular straight out line and
the wall the thickening is smooth

8. Saccular / Cystic Bronchiectasis - Bronchi severly
dialated, large areas of distal end look like ‘grape’,
bronchi end blindly in a dialated thick walled cyst
–

9. Varicose Bronchiectasis - resemble like varicose
veins, irregular/ altering dialation and constriction ,
irregular wall thickening

10. “
”
 Widened Airway lumen
Excessive mucous/ pus production
Damaged cilia

11. Pathophysiology
Primary inflammation to bronchi
Increase mucous viscosity
Recurrent transmural infections
Infiltrations of neutrophils, t. lymphocytes
Increases the elastase enzymes,
TNFalpha, Leads to loss of elasticity
Bronchial dialation/ tissue distruction

12. Clinical features
Shortness of breath
Cough with lot of mucous – green/ yellow
sputum upto 240ml
Purulant expectoration – the volume of the
sputum can be estimating the severity of the disease.
Clubbing of finger

13. Hemoptysis
Systemic manifestations –fever, weight loss
Reccurant Pneumonia
Wheezing in wide spread bronchiectasis

14. On auscultation :
Fine crackles
Coarse crepts
Bronchial breathing
Bronchitis
Consolidations
Collapse
Cavitation

15. Diagnosis
History and physical examination
Blood tests
Pulmonary function tests – ( LOW FEV1/ FVC in Ratio)
Oxygen saturation
Radiology: Chest X-Ray- Tramtrack lines
Sinus radiographs
HRCT Chest – ‘Signet ring’sign

16. Sputum culture to identify the bacteria-
pulmonary,H. influenza,
Broncoscopy
Special investigations – IgA immunoglobulins
Detection of cystic fibrosis by sweat chloride
test
 Barium test to identify GERD

17. Complications :
 Lung abscess
 Pleural effusion. Pleurasy, Empyema
 Corpulmonale
 Cerebral abscess
 Amyloidosis
 Pneumonia

18. Treatment:
Eliminate the cause
Control the infection
Oxygen therapy
Inhalation of nebulized broncho dialators –
Isoproterenol
Alpha antitrypsin replacement therapy

19. Postural drainage-
Bronchiectasis usually
affects the lower lobe of
the lungs,so acc. to
accumulation in the lungs,
the positional changes
should be follow to easy
drain of mucous or pus

20. Antibiotics:
• To delays cystic fibrosis
Amoxycilline 500mg/ 10 to 14 days
Ciprofloxacine 500mg/ 2weeks
• IV antibiotics-
Gentamycine 80mg / bd
Ceftadizime 2gm/ tds
Piperacilline 4.5gm/ tds
• IV Immunoglobuline
• Tobramycine 300mg/bd solution for inhalation

21. Surgical :
• Indications in damage/disease confined to one lobe or
segment
• Uncontrolled hemoptysis – bronchial artery embolization
 Lung transplant
 Surgical Resection
 Removal of viscous secretions/ foreign bodies/ mucous/ pus

22. Preventive and supportive treatment:
• Nutritional support
• Adequate hydration
• Healthy lifestyle
• Avoid smoking

23. Summery
BRONCIECTASIS Is an extreme form of obstructive
bronchitis, leads to perminant/ abnormal dialation and
distortion of bronchi and bronchioles.
Bronchitis also have similar Symptoms like Bronchiectasis, by
investigations and thorough examination will be rule out the
actual diagnosis.