Some Clinical Problems in Bronchiectasis

¹ Rochester, Minnesota

Bronchiectasis is a serious disease, frequently a fatal one, but is not accorded the attention that it deserves. It is frequently preventable, is occasionally curable, and may be difficult to diagnose accurately. Symptoms of bronchiectasis may be confused with those of chronic infection of the upper part of the respiratory tract. Bronchiectasis that is confined to an upper lobe may be very atypical, clinically and roentgenologically. Bronchiectasis may be caused by postpneumonic bronchial obstruction, obstructing bronchial tumors, long retained foreign bodies and developmental defects. True bronchiectasis appears to be incurable by any medical treatment and requires surgical extirpation. Selection of patients for operation requires close cooperation between the internist, the roentgenologist, the bronchoscopist and the surgeon. Bronchoscopy is frequently required and bronchographic studies with iodized oil are usually necessary to properly evaluate the situation. Many instances of "postpneumonic" bronchiectasis might be prevented if all patients with acute pulmonary infections were followed roentgenographically after clinical recovery. It is suggested that clinical judgment should be guided by roentgenography in management of acute pulmonary disease as it now is in the management of tuberculosis.