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Bronchiectasis

Bronchiectasis is defined as an abnormal, frequently permanent, dilation of bronchial tree. The bronchial tree consists of airways that branch off the trachea (windpipe) to convey air to and from the lungs. Patients with bronchiectasis have impairment in their ability to clear out secretions from their lower respiratory passages. Stagnant secretions pool in these airways and may become infected. These infections lead to further destruction of bronchial structure and thus a cyclic (reinforcing) process ensues. Nearly half of the cases are associated with cystic fibrosis. Other associated conditions include ciliary dyskinesia (Kartagener's syndrome), congenital and acquired immunodeficiency states, chronic obstruction of the bronchial tree by either tumors or foreign bodies, and inhalational injuries.

The most common symptoms of bronchiectasis are cough and expectoration of large volumes of phlegm (mucous). Other symptoms include hemoptysis (coughing up blood) and recurrent pneumonia. When bronchiectasis is suspected, the physician first takes a detailed medical history with attention to prior infections and patient symptoms. On listening to the lung, the physician can frequently appreciate abnormal sounds known as pulmonary crackles. Chest x-rays, HRCT (High resolution CT scan), and pulmonary function tests help confirm the diagnosis and assess the severity of this process. Patients with bronchiectasis are managed by maneuvers to remove and reduce bronchial secretions (daily postural drainage and chest percussion), inhaled bronchodilators, and antibiotics to treat infectious complications.

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