DISEASES OF THE RESPIRATORY SYSTEM : BRONCHIECTASIS (BRONCHIECTASIA) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Inflammatory infiltrate walls bronchus and in violation of its power due to peribronchovascular of vascular lesions cause the development of connective tissue in the bronchial wall, and loss of its elasticity. The lost elasticity of the bronchi are subjected to tension in the presence of the corrugator cicatricial processes in the nearby pneumocystitis areas of the lung, resulting in bronchiectasis.
All pulmonary processes leading to the development of bronchitis, peribronchial and pneumoconiosis, can cause bronchiectasis. These include:
Are early symptom drum your fingers. General condition and appearance of patients for a long time remain satisfactory, but in the later periods develops pallor or cyanosis, puffy face, fatigue.
The main symptom is cough, the intensity of which varies with the change of body position. The cough is accompanied by release of large amounts of purulent three-layered, often with a putrid odor and blood sputum containing elastic fibers.
Hemoptysis can be minor or very abundant. Sometimes hemoptysis is the only manifestation of bronchiectasis. The blood is unmixed with phlegm (a"dry" bronchiectasis). Most characterized by the presence in paravertebralna areas, often in axillary areas, the copious amounts is very stable sonorous medium and krupnoplastinchatam wheezing. Data less constant percussion: a percussion sound can have a boxed character or dulled depending on the severity of pneumoconiosis.
X-ray picture polymorphic. In cylindrical bronchiectasis visible linear Yuni and bright, with double contours of the strip. In saccular bronchiectasis occurs sevigny mesh pattern with the circle shadows.
To confirm the diagnosis using the filling of the bronchi yodolipola. Heart develops hypertrophy of the right ventricle, in the later stages of right heart failure (cor pulmonale, pulmonary heart-see diseases of the circulatory organs) with congestive liver and peripheral edema.
The disease is chronic, lasting for years. In the first period there is only negligible signs of bronchitis. The second period is characterized by frequent focal outbreaks (bronchiectasis) pneumonia and periodicals Department of a significant amount of purulent sputum. The third period is characterized by chronic pulmonary suppuration with General intoxication and a constant increase in temperature.
The most difficult differential diagnosis of abscess and bronchiectasis. Unlike abscess bronchiectasis bugged usually a lot of wheezing, sputum do not reveal elastic fibers. Often decides the diagnosis x-ray examination. Tuberculosis and metatuberculosis processes are also closely resemble bronchiectasis, especially metatuberculosis peribronchial and bronchitis are often the cause of bronchiectasis.
Depends on the type and stage of the disease. In dry bronchiectasis, the most dangerous are profuse bleeding; chronic suppuration of intoxication, exhaustion. With the development of amyloid-lipoid nephrosis, the prognosis is extremely unfavorable.