Bronchiactasis

Dr. Randula Samarasinghe

 Definition
Bronchiectasis is an abnormal and
permanent dilation of bronchi
May be focal or diffuse
 Pathogenesis
Infection and Inflammation of
bronchial walls

Impaired respiratory mucosal Destruction and

immunity and collection of dilation of
secretions airways
 Pathology
Dilation usually in medium sized airways
Normal structural components destroyed
and may be replaced by fibrous tissue
Dilated airways contain pools of thick
purulent material
Microscopically there is bronchial and
peribronchial inflammation and fibrosis,
ulceration of bronchial walls, squamous
metaplasia and mucous gland hyperplasia
 Lung parenchyma distal to the
dilated airway is also abnormal with
varing degree and combination of
fibrosis, emphysema,
brochopneumonia and atelectasis
 Causes
Infective
- Virus ( adeno virus , influenza )
- Bacterial infection
- TB
- HIV
Air way obstruction
Primary immune deficiency disorders
Immunoglobulin deficiency
Primary ciliary diskinasia
Cystic fibrosis
Allergic bronchopulmonary aspergillosis
 Clinical features
Cough productive , persistent and
purulent
Haemoptysis
Examination Clubbing, coarse
crackles, ronchi
 Investigations
Laboratory
Chest radiography May have cystic
shadows in the bases with air fluid
levels, tramline shadows and ring
shadows
High resolution CT ( HRCT )
 Treatment
Postural drainage
Antibiotics
Bronchodilators
Steroids
Surgery
Thank you