Bronchiectasis as a Pediatrician Sees It

¹ Los Angeles, California

Only in more recent times has it become evident that there is an intimate cause and effect relationship between three apparently isolated clinical entities. These three, bronchiectasis, the collapsed lung, or atelectasis, and the triangular shadow at the base of the lung in the x-ray film have been well known and described. The one etiologic factor common to all three entities is complete obstruction of the lumen of the main bronchus of a lung or of one or more lobes or of a part of a lobe.

Bronchiectasis, at least in childhood, is an evolution from a prebronchiectatic state that is commonly recognizable and as commonly curable. Bronchiectasis is nearly always preceded by atelectasis and atelectasis occurs whenever there is complete bronchial obstruction. Much of the bronchiectasis can be prevented by the early recognition and cure of atelectasis through the relief of bronchial obstruction. The removal of foreign bodies, the bronchoscopic aspiration of obstructing secretions and postural drainage are all indicated as preventive measures. Surgical removal of the diseased lobe or lung offers the only certainty of cure for an established case of bronchiectasis.