Bronchiectasis – How It Develops and What the Possible Complications Are

As the largest of the airways, the trachea has two main branches – the bronchi, each of which is tree-like and branches into hundreds of small bronchi. When the elastic and muscular elements that make up the bronchi are damaged, this leads to bronchiectasis.

How does bronchiectasis develop?

The most common causes of bronchiectasis are recurrent airway inflammations and various infections. Sometimes they start in childhood. About a third of cases may be due to cystic fibrosis. Bronchiectasis can also be caused by certain genetic or allergic diseases.

Bronchiectasis has different forms, depending on the pathological enlargement of the bronchi themselves: cylindrical, varicose, and saccular or cystic.

On the other hand, their dilations can be only on one or both sides. When their ciliated epithelium is destroyed, tough secretions are usually retained and ulcerative lesions occur. The lumen of the bronchi may become blocked and parts of the lungs may be left without air.

Bronchiectasis is sometimes discovered by chance by a pulmonologist without any complaints. If inflammatory secretions accumulate as a result of bronchiectasis, the disease progresses and has several main manifestations:

Cough

It is the most common symptom and is accompanied by purulent sputum, especially in the morning in winter. These periods may be followed by “dry” ones, without expectoration. Sputum blood may also appear as the first symptom of the disease.

Lung infections

Very often they are recurrent and located in the area of ​​bronchiectasis. They can be pneumonia, bronchitis, various lung abscesses, pneumothorax, empyema. Chronic respiratory and heart failure may also develop.

Recurrent haemoptysis

The temperature is higher, and it is possible to stay that way for months. Other manifestations include bad breath, fatigue, weight loss and anemic syndrome, puffiness, bluish complexion. Shortness of breath and chest pain may occur, and this, being a late symptom, may indicate the formation of fibrous tissue.

If a child has congenital bronchiectasis, it lags behind in physical development and has a weak and frail physique, may have nail clubbing and often chronic sinusitis as a concomitant disease.

What complications can occur with bronchiectasis?

A disease such as bronchiectasis occurs with periods of exacerbation alternating with remissions. As the disease progresses, possible complications can be:

• right heart failure (pulmonary heart);
• hemorrhage;
• below-normal level of oxygen in blood (hypoxemia);
• frequent pneumonia;
• abscess collection of pus in the pleural cavity (empyema);
• sepsis as a result of purulent infections;
• rarely, metastatic lesions in other organs.

The prognosis for the disease depends on the type of causative agent. Treatment is aimed at controlling infections and reducing secretions, relieving airway obstruction and reducing the risk of complications. With appropriate therapy, most patients can live a normal life. In order to prevent the development of the disease, risk factors must be excluded and diseases of the respiratory system must be timely treated.