Bronchiectasis

Bronchiectasis is a designation for condition when there are areas of abnormally dilated bronchi in patient’s lungs. This pathology is connected with many complications, usually with repeated respiratory infections. How does bronchiectasis form and how does it manifest?

Causes

Bronchiectases can be congenital or acquired. Congenital exist on basis of genetically defect bronchial cartilage. Bronchi are shaped tubes stiffened by cartilage. If the cartilage is defective, it is unable to maintain tubular shape of the bronchi and they start to dilate.

 

Acquired bronchiectases arise as a consequence of other diseases and congenital disorders. Bronchi can be damaged and widened by repeated pneumonias, especially in children. Accumulation of mucus in bronchi in cystic fibrosis or Kartagener syndrome may also be cause of bronchiectases. Bronchial expansions emerge even in tuberculosis and processes associated with pulmonary fibrosis. As an example I could mention silicosis and asbestosis.

 

Symptoms

Dilated bronchi begin to accumulate mucus that should be in normal conditions evacuated by cilia movement out of the respiratory tract. This is manifested by frequent attacks of wet cough with expectoration of mucus and sometimes with blood expectoration.

 

Once the body begins to accumulate a fluid, it's always a good place for bacteria proliferation. The whole process gets complicated by recurrent bacterial pneumonias with symptoms like high fever, cough with expectoration of mucopurulent discharge and chest pain. The process is associated with shortness of breath, and overall deterioration of the patient (weight loss, loss of appetite). If this condition persists long-term and affects a large part of lung tissue, it can impair pulmonary exchange of breathing gases. It worsens blood flow through the lungs, increases blood pressure in lung tissue and that leads to overload of the right heart ventricle. Such chronic overload can cause a heart failure.

Diagnosis

Symptoms such as persistent cough with expectoration of mucus and repeated pneumonias are suspicious. It is however quite difficult to diagnose a bronchiectasis. Chest X-ray is not very reliable; probably the best choice is a computed tomography scan.

Treatment

Bronchiectasis is a condition that can not be healed by conservative means. The key of conservative approach is to thoroughly treat recurrent pneumonias with antibiotics and administer drugs to enable better dissolution and coughing up of phlegm (mucolytic agents). If symptoms are too severe and conservative approach is unsatisfactory, surgical solution is possible. A thoracic surgery intervention is performed with removal of affected lung tissue.