Bronchoscopy in Bronchiectasis

¹ Philadelphia, Pennsylvania

Bronchiectasis is a common chronic pulmonary disease being more often observed than pulmonary tuberculosis. It involves the peripheral portion of the bronchial tree, commonly involving a lower lobe and more often the lower lobe of the left lung. It is common in children, and while it may be congenital in origin, in a majority the disease is acquired and is secondary to previous bronchopulmonary infection. The morbidity and mortality rate of bronchiectasis is higher than is generally appreciated. Bronchial infection and obstruction interfering with drainage are the most important etiological factors. Surgical extirpation of the diseased lung tissue will effect a cure. All other methods of therapy are palliative only.

The bronchoscopic findings vary. In dry bronchiectasis there may be nothing abnormal noted bronchoscopically. In the infected form purulent secretion, inflammatory changes or bronchial obstruction may be observed. However, the final diagnosis is based on a roentgen study of the bronchial tree following instillation of iodized oil by one of numerous methods described.

Considerable stress is laid on the importance of bronchoscopy as an aid in the prevention of bronchiectasis through the removal of bronchial obstruction. Bronchoscopic aspiration of secretions from infected areas aids patients who are too old for surgery or who have bilateral lesions which render surgical treatment impractical.