Bronchiectasis is the irreversible dilatation of the airways that can involve parts of the lung in a focal or diffuse manner. It is commonly categorized as cylindrical, varicose, or cystic. Focal bronchiectasis occurs in a localized area due to obstruction of an airway from external factors like tumors or internal factors like aspirated objects. Diffuse bronchiectasis is widespread throughout the lungs and often arises from underlying systemic or infectious diseases. Clinical manifestations include a persistent productive cough with thick sputum, clubbing of the fingers, and crackles heard on examination. Diagnosis is usually based on presentation and radiographic findings, with CT scans being more specific than chest X-rays. Treatment

1. BRONCHIECTASIS
DR GOURI MOHAN

2. DEFINITION
Irreversible dilatation of airway that
involves lung in either Focal or Diffuse
manner and that classically has been
categorized as Cylindrical or Tubular (the
most common form), Varicose & Cystic.

3. PATTERN OF
LUNG
INVOLVEME
NT
FOCAL BRONCHIECTASIS
 Localised area
 Consequence of obstruction of airway
 Extrinsic : adjacent lymphadenopathy/tumour/mass
 Intrinsic : airway tumour, aspirated foreign body,
scarred / stenotic airway.
DIFFUSE BRONCHIECTASIS
 Widespread bronchiectasis changes throughout lung
&
 Often arises from an underlying systemic or
infectious disease process

4. CLASSICAL
CATEGORIES
Cylindrical or Tubular
Varicose
Cystic

7. Upper Lobe
Cystic Fibrosis
Tuberculosis
Central
ABPA
CongenitalTracheobronchomegaly
Lower Lobe
Chronic recurrent aspiration
End Stage fibrotic lung disease
Recurrent immune deficiency ass. infection

8. PATHOPHYSIOLO
GY

10. CLINICAL MANIFESTATION

11. CLINICAL
MANIFESTATIO
N
 Persistent productive cough with ongoing
production of thick tenacious sputum.
 O/E : Clubbing (+)
 Early and mid inspiratory coarse crackles
and Diffuse rhonchi

12. DIAGNOSIS
 Usually based on presentation +
radiographic findings
 Chest radiography lacks sensitivity
 CT – more specific

13. DIAGNOSIS

18. TREATMENT
Bronchial Hygiene : enhancing secretion
clearance – hydration and mucolytic
administration
Nebulisation with Hypertonic saline, Chest
Physiotherapy(postural drainage)
Pulmonary rehabilitation and a regular
exercise program to improve quality of life
Anti-inflammatory therapy
Antibiotics in case of acute exacerbations
Surgery – Refractory cases
Lung transplant – In advanced cases

19. COMPLICATION
S
Recurrent Infections
Massive hemoptysis
Antibiotic resistance

20. PROGNOSIS
Depends on underlying etiology and
frequency of exacerbation

21. PREVENTION
 Vaccination of patient with chronic respiratory conditions to
decrease risk of recurrent infections
 Smoking cessation

22. THANK YOU