 |
| Bronchiectasis |
Bronchiectasis
Permanent abnormal dilatation of one or more bronchi due to the destruction of elastic n muscular components of d bronchial wall.
CLASSIFICATION
1 SACCULAR BRONCHIECTASIS
- Occurs in d proximal large bronchi
- bronchi shows large dilatation, ending in large sacs.
2 CYLINDRICAL
- Invoves d airway frm 6th to 10th generation.
- bronchi look cylindrical or beaded.
3 VARICOSE
- Bronchi resemble varicose vein
AETIOLOGY
CONEINITAL
bronchial cysts, bronhomalacia, cystic fibrosis,
ACUQIRED( chldren )
necrotizing pneumonias, primary. TB,etc
ACUQIRED( adults )
pulmonary TB, suppurative pneumoias. Postoperative bronchiectesis, tumour or froeign body etc
PATHOLOGY
- Characteristic faature is multiple bronchiectatic cavities.
- left lung is involve mor than right
- lower lobe is involve mor than upper
- common site- lower lobe, lingula, n middile lobe.
C/F
- chronic cough wit sputum production , haemoptysis n recurrent pneumonias.
- sputun is copious, purulent n foul smelling. Maximun in 1st 2 hrs after waking up.
- tree layer sputum - mucoid layer on d top, mucnpurulent in d middle n purulen at d bottom.
- haemoptysis is due to rupture of d thin walled vessels.
- dyspnoea n wheezing
- systemic symp. Like fiver, wt loss, anaemia, night sweats n weakness.
PHYSICAL FINDING
- gen. Exam^- anaemia, clubbing. Five, halitosis n sinusitis.
- bilateral, basal, coarse, leathery creapitation.
INVESTIGATIONS.
- BLOOD- anaemia, raise ESR n leucocytosis.
- URINE- proteinuria wit anyloidosis
- SPUTUM - gm stain. zn stain, culture sensitivity.
- CHEST X ray- usually norm. Cystic or saccular type diagnosed by multiple 1 to cm cystic lesion wit or witout fluid levels.
- ECG usually norm.
- BRONCHOSCOPY
- BRONCHOGRAPHY
- CT SCAN
- PULMONARY FUNCT^ TEST - may shows obstruction.
- ARTEIAI BLOOD GAS STUDIES-shows respiratory alkolosis or hypoxaemia
- IMMUNOLGIC SURVEY
COMPLICTION
- Haemoptysis
- Pneumonia
- Lung abscess
- Septicaemia
- Brain absces
- Respirtotry failure
- Emphyema
MANAGEMENT
1 Treat underlying cause
2 Drainage
3 Antibiotics
- choic depends on culture n sensitivity
- mild- oral agent like amoxicillin, amphicillin, tetracyclin, cotrimoxazole. Shud b use
- sever- parentral antibiotic used
4 Bronchodilators
- it improve obstruction n aid clearance of secreation.
5 Surgical treatment
- Indications.
- child or young adult wit localised lesion
- recurrent haemoptysis
- recurrent localised pneumonias.
6 Other
- cigarette smoking should b stop
- episodes of sinusitis should b treat promptly.
- complicated case may require nasal oxyen on a chronic basis.
-by pam
1 comments:
I was diagnosed of Herpes 2years ago and I have tried all possible means to get the cure but all to no avail, until i saw a post in a health forum about a Herbal Doctor(Dr imoloa who prepares herbal medicine to cure all kind of diseases including Herpes, at first i doubted, if it was real but decided to give him a trial, when i contacted Dr imoloa through his Email: drimolaherbalmademedicine@gmail.com he guided me and prepared a herbal medicine and sent it to me via courier Delivery service,when i received the package (herbal medicine) He gave me instructions on how to consume it, i started using it as instructed and i stop getting outbreaks and the sores started vanishing, could you believe i was cured of this deadly virus within two to three weeks and notices changes in my body. Days of using this REMEDY,couldn't believe the healing at first until i see it as my HERPES get cleared like magic Dr imoloa also use his herbal medicine to cure diseases like, HIV/aids, lupus disease, dry cough, fever, malaria, bronchitis disease, Lyme disease, acute myeloid leukaemia, alzheimer's disease, blood poisoning, measles, kidney cancer, kidney infections, diarrhoea, epilepsy, joint pain, mouth ulcer,bowel cancer, discoid eczema, eye cancer, food poisoning, fibroid, hairy cell leukaemia, mouth cancer, skin disease, lung cancer, liver disease, penile cancer, parkinson disease, arthritis, breast cancer, bone cancer hepatitis A.B.C, Diabetes, fatigue, muscle aches, anal cancer, asthma, Contact this great herbal Doctor today the father of herbalism. via Email: drimolaherbalmademedicine@gmail.com or whatssapp him +2347081986098. and get cured permanently He is real..
EmoticonEmoticon