What is Bronchiectasis?
Bronchiectasis is a chronic disease characterized by progressive and irreversible enlargement and sac formation in the bronchial system due to infection and other causes. Due to the damage to the airway, the airway’s mucus production and self-cleaning mechanisms are impaired, leading to an increased susceptibility to infections.
What are the symptoms of bronchiectasis?
Characterized by a chronic cough and sputum production, there are periods of fever with intervening infections and attacks with abundant sputum in bronchiectasis. But at other times, there is always complaints of increased sputum production, coughing, and often bad breath odor. Rarely, blood can be seen in sputum. Blood in sputum is an important finding and indicates the possibility of life-threatening bleeding in the future. The typical blunting of the fingertips called clubbing is also an important finding in these patients.
Bronchiectasis is diagnosed with clinical and radiologic findings. Although infiltrative lung areas are observed on direct chest radiography, the main diagnostic test is high resolution computed tomography.
According to its appearance on computed tomography, it is subdivided into;
– ciliated
– varicose
– cystic subtypes.
It is also important to distinguish whether it is localized or diffuse and whether it involves one lung or both.
What are the causes of bronchiectasis?
– Severe or poorly treated infections, especially in childhood,
– Foreign body aspiration or obstruction that may cause long-term obstruction of the bronchus
– Some congenital diseases; cystic fibrosis, Kartegener syndrome, immotile cilia syndrome, alpha-1 antitrypsin deficiency, radiotherapy, etc.
In these conditions, bronchial damage will develop over time. Because the self-cleaning mechanism of the airway is impaired or the mucus in the bronchi may be too thick.
How is bronchiectasis treated?
There is no cure for bronchiectasis; the disease can be controlled with appropriate treatment and precautions. Patients should be well treated with appropriate antibiotics during infection attacks. Complaints can be reduced with sputum softeners and breath fresheners. Respiratory physiotherapy training is also important.
In some cases, surgical treatment may be considered.
In which cases is bronchiectasis surgically operated?
-Frequent episodes of infection (more than two episodes of respiratory infection in a row for at least 2 years)
– Hemoptysis,
-Limited lung area, either in a single lung or, if bilateral, limited to only one lobe,
– The patient has no congenital disease causing bronchiectasis,
– The patient is fed up with complaints such as bad breath, excessive phlegm and has limited disease.
In surgical treatment, a lobe or a smaller part of it (the segment) where the disease is located is surgically removed. In this way, the complaints arising from this part are prevented alongside the spread of infections in this diseased part to other lung parts.
