Bronchiectasis

Bronchiectasis is a condition where there is chronic inflammation of the lobar bronchi which become dilated and chronically infected. It generally follows a childhood infection of which whooping cough used to be the commonest cause. It can be circular or cylindrical depending on the length of bronchus involved. These may be localized or generalized. Characteristically, patients have a persistent cough bringing up large amounts of purulent sputum each morning and are liable to intermittent haemoptysis.

Treatment consists of keeping the airways free of pus by postural drainage each morning and in severe cases later in the day as well and managing episodes of active infection. The main investigation used to be bronchography but this has been supplanted by high-resolution CT scans with 3D reconstruction, which is much better tolerated by the patient. Localized areas of bronchiectasis can be treated by surgical excision but widespread bronchiectasis is a medical condition requiring life-long management.

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