Bronchiectasis

Bronchiectasis is abnormal and permanent dilatation of bronchi and cartilaginous being, accompanied by destruction of muscle and elastic components of the walls.

Etiology and pathogenesis
A bronchial wall inflammation, causing damage and dilatation. Contributing factors are:

1. Infection: primary and secondary.
Primary or secondary infection, either repeatedly or continuously, by: bacteria, viruses, mycoplasma, and mycobacterial clearance mukosilia and will damage the airway epithelium.
In children is often caused by: measles, whooping cough, severe pneumonia or aspiration. Primary tuberculosis is often also leads to bronchiectasis.

Endobronchial tuberculosis causing necrosis, focal stenosis due to endobronchial inflammation, enlarged lymph nodes give emphasis or endobronchial obstruction, and scarring of the parenchyma causes distortion of the airway.

2. Inhalation of toxic chemicals or materials imunoaktif.
Inhalation of toxic chemicals or materials imunoaktif or autoimmune reaction: anhydrous ammonia vapor, sulfur oxides, talc, cork, bakelite, and smoke. Aspiration of gastric contents resulting in inflammation and result in bronchiectasis, for example in the hiatal hernia, gastric motility disorders, divertikuli, trakeoesofageal fistula.

3. An abnormal immune response: a genetic or acquired.
Abnormal immune response: a genetic or "acquired".
Swollen lungs because of heroin or heroin poisoning can cause bronchiectasis, due to changes in immunological defense.
Bronchiectasis occurs in patients with ulserosa colitis, rheumatoid arthritis, Sjogren's syndrome, cutaneous vasculitis, Hashimoto's thyroiditis, pernicious anemia, "primary biliary cirrhosis," "celiac disease", and sarcoid, because of an abnormal immunological manifestations, which often form hiperresponsif or autoimmune response.
4. Mechanical factors.
Atelectasis or parenchymal fibrosis can lead to bronchiectasis. Atelectasis can cause bronchial dilatation is back to normal when the lungs expand again. Parenchymal fibrosis can lead to bronchial dilation through withdrawal.
Bronchial dilatation and distortion may interfere with clearance mukosilier, leads to accumulation of secretions, resulting in infection with bronchial wall damage elements --> bronchiectasis.

5. Inherited or congenital abnormality.
Deficiency of alpha-1-antitrypsin causes emphysema panasinar and diffuse bronchiectasis.

• "Allergic bronchopulmonary aspergillosis" --> central or proximal bronchiectasis.
• BEAP syndrome (bronchiectasis, eosinophilia, asthma, and pneumonitis).
• Bronchiectasis is a picture that stands out in cystic fibrosis, in children and adults.
• Kartegener syndrome (bronchiectasis, sinusitis, site inversus).
• Young's syndrome: obstructive Azoospermia and lung abnormalities (bronchiectasis).
• "Pulmonary sequestration".
• Yellow nail syndrome.
• William Syndrome - Campbell (deficiency of bronchial cartilage generation 4 through 8).
• Swyer Yndrome - James and Mac Leod (hipertensi unilateral lung).
• Marfan's syndrome.

Clinical Symtomps and Diagnosis Bronchiectasis

Management of Bronchiectasis

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