Definition:

1. •dilatation of the bronchi
   

2. •includes partial destruction of the muscular coat and ciliated epithelium.
   

Pathogenesis :

1. •Infection
   

2. •Obstruction
   

3. •Destruction.
   

Forms:

1. •Localised
   

2. •Multisegmental
   

Classification:

1. •Postinfection saccular
   

1. ◦Pertussis, bacterial or viral pneumonia, bronchial stricture. retained foreign body
   

2. •Cylindrical
   

1. ◦Pulmonary infection
   

2. ◦Chronic aspiration (oesophageal dysmotiliy, achalasia, ca, TOF, senility)
   

3. •Pseudobronchiectasis
   

1. ◦temporary after pneumonia
   

4. •Post-tuberculous
   

1. ◦upper lobes
   

2. ◦cylindrical
   

3. ◦aspergillus
   

4. ◦middle lobe syndrome
   

5. •Genetic related.
   

1. ◦cystic fibrosis
   

2. ◦immotile cilia (situs inversus)
   

3. ◦a1 -anti trypsin
   

4. ◦immune deficiencies
   

6. Clinical findings
   

7. •Cough
   

8. •Sputum
   

9. •Haemoptysis
   

10. •Recurrent infections
    

Investigation

1. •CXR - PA and LAT
   

2. •Bronchoscopy
   

3. •Bronchogram
   

4. •CT scan - fine cuts.
   

Treatment of bronchiectasis

Prevention

1. •Foreign bodies
   

2. •Pertussis vaccination
   

3. •Early treatment of childhood pneumonias
   

4. •Genetic counselling
   

Medical

1. •Postural drainage
   

2. •Antibiotics
   

Surgical

1. •Limited resection
   

1. ◦Anaesthetic difficulties
   

2. ◦Adhesions
   

3. ◦Vascularity
   

2. •Devascularisation
   

3. •Transplantation
   

Complications

1. •Lung abscess
   

2. •Empyema
   

3. •Bronchopleural fistula
   

4. •Massive haematemesis
   

5. •Aspergilloma