Bronchiectasis: diagnosis, treatment and management

摘要

Bronchiectasis is the term given to abnormal irreversibly dilated and thickened bronchial walls. It is associated with recurrent cough, sputum production and recurrent chest infections. Bronchiectasis is caused by repeated insults to the lower respiratory tract, altering muco-ciliary clearance that leads to stasis of secretions, infection, inflammation and, eventually, destruction and dilatation of the peribronchial and bronchial tree. The anatomical distribution of bronchiectasis may suggest an underlying aetiology. Upper lobe bronchiectasis may suggest cystic fibrosis (CF)-related bronchiectasis, allergic bronchopulmonary aspergillosis (ABPA), sarcoidosis or tuberculosis. A localised distribution of bronchiectasis suggests external compression, retained foreign body or even past pneumonia (see Table 1). CF-related bronchiectasis has a different pathophysiology, therefore, its management is different and not covered in this article.