BRONKIEKTASIS

A. Definition
Bronchiectasis is a chronic disorder characterized by permanent
bronchial dilatation, accompanied by an inflammatory process in
the bronchial wall and surrounding lung parenchyma.

B. Classification
Morphologically bronchiectasis is divided into 3 types:
(1) Cylindrical bronchiectasis
or tubular, characterized by airway dilation.
(2) Bronchiectasis varicose (so named because the image is
similar to a varicose vein), characterized by a focal constrictive
area accompanied by airway dilation as a result of defects in the
bronchial wall.
(3) Cystic or sacular bronchiectasis, indicated by
progressive airway dilatation that ends in the cyst
large size, sac, or picture
grape-like clusters (this picture is a picture of most bronchiectasis
weight)
C. Epidemiology
The prevalence of bronchiectasis is reported to be increasing
in the United States. Seitz et al. Reported the prevalence of
bronchiectasis increased every year from 2000 to 2007 with
an increase of 8.74%, with a peak age of 80-84 years, more
commonly found in women, and Asian races.
D. Etiologi
Bronchiectasis results from damage to bronchial tissue that is
exacerbated by infection. Bronchial infections in people with
bronchiectasis increase the risk of infection in the lungs, which will
make the bronchi more inflamed and widened. Both of these occur
spinning and repeating, so that damage to the bronchi and lungs gets
worse.

Bronchial damage is triggered by an immune system response that

seeks to eliminate the cause of infection, such as bacteria and viruses.
The immune system's work triggers an inflammatory reaction. In
general, the inflammatory reaction will stop by itself without causing
tissue damage. However, in bronchiectasis, the inflammatory reaction
causes permanent damage to the elastic tissue and bronchial muscle
tissue. Damage to both tissues causes widening of the bronchi which
increases the risk of infection.

Various conditions and diseases that can trigger permanent damage to

the bronchial lungs, among others : PPOK, Primary Ciliary Dyskinesia,
Imunodefisiensi Humoral, and others.
E. Risk factors
There are many risk factors for this condition, namely:
• Absence or CFTR protein dysfunction in bronchial cells in
cystic fibrosis (CF)
• Has a systemic disease associated with bronchiectasis as
mentioned above
• Chronic or severe pulmonary infection (such as
tuberculosis) that damages the respiratory tract.
F. Pathophysiology
Bronchiectasis can occur in damage directly from the
bronchial wall or indirectly from intervention in the normal
airway defense. Airway defense consists of small cilia on the
airway. The cilia move repeatedly, moving fluid in the form of
mucus that normally lines the airway. Harmful particles and
bacteria trapped in the mucous layer will be moved up to the
throat and then coughed out or swallowed.
 Regardless of whether the damage is caused directly or
indirectly, the bronchial wall area is damaged and becomes a
chronic inflammation. Inflammatory bronchi will lose elasticity,
so the bronchi will become wide and flabby and form a sac or
sac that resembles a small balloon. Inflammation also
increases mucus secretion. Because ciliated cells are
damaged, the secretions produced will accumulate and fill
the airway and become a place for bacteria to develop.
Which ultimately these bacteria will damage the bronchial
wall, so that it becomes a vicious circle between infection and
airway damage.