Bronchiectasis is the permanent abnormal dilatation of the bronchi and bronchioles. It has both congenital and acquired causes such as tuberculosis, pneumonia, and inhaled foreign bodies. Clinically, it manifests as chronic cough, production of large amounts of purulent sputum, and recurrent pneumonia. Diagnosis involves chest imaging like CT scan and testing sputum samples. Treatment focuses on controlling infections with antibiotics, improving mucus clearance, and potentially surgical resection of severely affected areas.

1. BRONCHIECTASIS
KHAWAJA TAIMOOR SHAHID
M.Phil Zoology, M.Ed
Department of Zoology
Superior College M.B.DiN

3. DEFINITION:
🞭 Bronchiectasis
is defined as
permanent,
abnormal
dilatation of one
or more large
bronchi.

4. DEFINITION:
Bronchiectasis is defined as
abnormal and irreversible dilatation
of the bronchi and bronchioles
(greater than 2mm in diameter)
developing secondary to
inflammatory weakening of bronchial
walls.

6. ETIOLOGY:
🞭Bronchiectasis has both
congenital and acquired
causes.

7. THE YELLOWISH DISCOLORATION OF LUNG
PARENCHYMA REFLECTS OBSTRUCTIVE PNEUMONIA.

8. ACQUIRED CAUSES
🞭 Tuberculosis,
🞭 pneumonia,
🞭 inhaled foreign bodies,
🞭 allergic bronchopulmonary aspergillosis and
bronchiol tumours are the major acquired
causes of Bronchiectasis.

9. INFECTIVE CAUSES ASSOCIATED WITH
BRONCHIECT
ASIS INCLUDE
🞭 infections caused by
the Staphylococcus,
Klebsiella, or
Bordetella pertussis,
the causative agent of
whooping cough.

10. ASPIRATION OFAMMONIAAND OTHER T
OXIC
GASES,
🞭 pulmonary aspiration,
🞭 alcoholism, heroin (drug use),
🞭 various allergies all appear to be linked
to the development of Bronchiectasis

11. 🞭 Childhood Acquired Immune Deficiency
Syndrome (AIDS), which predisposes patients
to a variety of pulmonary ailments, such as
pneumonia and other opportunistic infections.
🞭 Inflammatory bowel disease, especially
ulcerative colitis.
🞭 A Hiatal hernia can cause Bronchiectasis when
the stomach acid that is aspirated into the
lungs causes tissue damage.

12. CONGENITAL CAUSES
🞭 Kartagener syndrome
🞭 primary immunodeficiencies
🞭 Marfan’s syndrome.
🞭 Patients with alpha 1-antitrypsin deficiency
have been found to be particularly
susceptible to bronchiectasis,

13. Varicose bronchiectasis
4. Diagnosis – Chest CT

14. Cystis / saccular
bronchiectasis
4. Diagnosis – Chest CT

16. Due to etiological factor
Inflammation of bronchial wall
causing
Loss of supporting structure
Result in
Thick sputum that obstruct the bronchi
The bronchial wall become
permanently dialated and

17. CLINICAL MANIFESTATION
1. The production of large quantities of purulent
and often foul-smelling sputum.
The volume of sputum can be used for
estimating the severity of the disease
🞭 Mild < 10 mL
🞭 Moderate 10~150 mL
🞭 Severe >150 mL

18. 2. Chronic cough
3. Hemoptysis:
🞭Frequent
🞭More commonly in dry variety
🞭 Usually mild (blood streaking of purulent
sputum)
🞭Massive hemoptysis is usually from
dilated bronchial arteries or bronchial-
pulmonary anastomoses under systemic
pressure

19. 4. Recurrent pneumonia:
same segment
5. Systemic manifestations:
fever, weight loss

20. SIGNS AND SYMPTOMS
🞭 Chronic cough with foul smelling sputum
production,
🞭 Some people with bronchiectasis may
produce frequent green/yellow sputum (up to
240ml (8 oz) daily).
🞭 Bronchiectasis may also present with
hemoptysis
🞭 Pneumonia
🞭 Bad breath indicative of active infection.
🞭 Frequent bronchial infections and
breathlessness are two possible indicators of

21. DIAGNOSTIC EVALUATION:
🞭 History and physical examination
🞭 Chest x-ray
🞭 CT (computerised tomography) scan
🞭 Blood tests
🞭 Testing of the mucus to identify any bacteria
present
🞭 Checking oxygen levels in the blood
🞭 Lung function tests (spirometry).

22. Dilated bronchus
BRONCHIECTASIS

23. COMPLICATION
Local complication
🞭 Recurrent pneumonia
🞭 Lung abcess
🞭 Empyema
🞭 Hemoptysis
🞭 Pulmonary hypertension

24. Systemic complication
🞭 Hypoproteinemia &amyloidosis
🞭 Generalized edema (100gm sputum/4_5 g
protein)protein loosing pneumopathy

25. TREATMENT
🞭 Treatment of bronchiectasis includes
🞭 controlling infections and bronchial
secretions,
🞭 relieving airway obstructions,
🞭 removal of affected portions of lung by
surgical removal or artery
embolization
🞭 preventing complications.

26. TREATMENT
Therapy has several major goals:
(1)Treatment of infection, particularly during acute
exacerbations
(2) Improved clearance of tracheobronchial secretions
(3) Reduction of inflammation
(4) Treatment of an identifiable underlying problem

27. TREATMENT
🞭 Medical management
1.Improving the drainage of airway
1) expectorant
2) bronchodilators
3) postural drainage

28. 2. Antibiotic
🞭 The choice of antibiotics should be
accurately by the results of
sputum culture and drug sensitivity
test.
🞭 Empirical therapy ---
antipseudomonal antibiotics.

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🞭 Antibiotics are used only during acute
episodes
🞭 Choice of an antibiotic should be guided by
gram's stain and culture of sputum
🞭 Empiric coverage (amoxicillin, co-
trimoxazole,levofloxacin) is often given
initially

30. 🞭Surgicalresection
🞭Bronchialarterialembolization
🞭
Althoughresectionm
a
ybesuccessfulifdisease
islocalized,embolizationispreferablew
ith
widespreaddisease