Reversible bronchial dilatation in adults

2021 ◽  
Author(s):  
Jun Zhang ◽  
Sijiao Wang ◽  
Changzhou Shao
Keyword(s):  
Bronchial Dilatation

scholarly journals Serial computed tomography findings of Coronavirus disease 2019 (COVID-19) pneumonia treated with favipiravir and steroid therapy: report of 11 cases

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Naoki Irizato ◽  
Hiroshi Matsuura ◽  
Atsuya Okada ◽  
Ken Ueda ◽  
Hitoshi Yamamura
Keyword(s):  
Computed Tomography ◽  
Mechanical Ventilation ◽  
Steroid Therapy ◽  
Time Course ◽  
Ground Glass ◽  
Time Points ◽  
Ct Findings ◽  
Mixed Pattern ◽  
Bronchial Dilatation

Abstract Background This study evaluated the time course of computed tomography (CT) findings of patients with COVID-19 pneumonia who required mechanical ventilation and were treated with favipiravir and steroid therapy. Results Eleven patients with severe COVID-19 pneumonia were included. CT findings assessed at the three time points showed that all patients had ground-glass opacities (GGO) and consolidation and mixed pattern at intubation. Consolidation and mixed pattern disappeared in most of the patients whereas GGO persisted in all patients at 1-month follow-up. In addition to GGO, a subpleural line and bronchus distortion and bronchial dilatation were frequent findings. The degree of resolution of GGO varied depending on each patient. The GGO score correlated significantly with the time from symptoms onset to initiation of steroid therapy (ρ = 0.707, p = 0.015). Conclusions At 1-month follow-up after discharge, non-GGO lesions were absorbed almost completely, and GGO were a predominant CT manifestation. Starting steroid therapy earlier after onset of symptoms in severe COVID-19 pneumonia may reduce the extent of GGO at 1-month follow-up.

Acute Respiratory Distress Syndrome

Chest Imaging ◽  
2019 ◽  
pp. 77-82
Author(s):  
Brent P. Little ◽  
Travis S. Henry
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Drug Toxicity ◽  
Distress Syndrome ◽  
Diffuse Alveolar Damage ◽  
Imaging Findings ◽  
Progressive Dyspnea ◽  
Bronchial Dilatation ◽  
Inspired Oxygen ◽  
Diffuse Lung

Adult respiratory distress syndrome (ARDS) is a clinical diagnosis of diffuse lung injury leading to severe hypoxemia in spite of high inspired oxygen concentrations. Histologically, ARDS manifests as diffuse alveolar damage (DAD). Intrapulmonary causes of ARDS include pneumonia, inhalational injuries, aspiration, and chest trauma. Extrapulmonary or systemic causes include sepsis, multi-organ failure, transfusion reaction, pancreatitis, and drug toxicity. The early exudative phase occurs within 72 hours of the precipitating cause, and usually manifests with diffuse bilateral airspace opacities. The organizing phase occurs later, with a dependent gradient of consolidation worse in the posterior lower lungs; bronchial dilatation may develop rapidly. In survivors, the lung may return to a relatively normal state, or may develop fibrosis. Fibrosis is often more severe in the anterior portions of the lungs due to the protective effect of the typically posterior, dependent consolidation and atelectasis of ARDS. Imaging findings of ARDS may appear in patients with progressive dyspnea and tachypnea who require mechanical ventilation. Pneumothorax may occur in patients with ARDS due to barotrauma, with minimal loss of volume of the ipsilateral lung due to its increased density and decreased compliance

scholarly journals ROSE: Radiology, Obstruction, Symptoms and Exposure, a Delphi consensus definition of the association of COPD and Bronchiectasis by the EMBARC Airways Working Group

2021 ◽  
pp. 00399-2021
Author(s):  
Letizia Traversi ◽  
Marc Miravitlles ◽  
Miguel Angel Martinez-Garcia ◽  
Michal Shteinberg ◽  
Apostolos Bossios ◽  
...  
Keyword(s):  
Chronic Obstructive ◽  
Delphi Consensus ◽  
Consensus Definition ◽  
Obstructive Pulmonary Disease ◽  
European Consensus ◽  
Toxic Agents ◽  
And Gender ◽  
Definition Of ◽  
Bronchial Dilatation ◽  
Worse Prognosis

IntroductionThe coexistence of chronic obstructive pulmonary disease (COPD) and bronchiectasis (BE) seems to be common and associated with a worse prognosis than for either disease individually. However, no definition of this association exists to guide researchers and clinicians.MethodsWe conducted a Delphi survey involving expert pulmonologists and radiologists from Europe, Turkey and Israel in order to define the “COPD-BE association”.A panel of 16 experts from EMBARC selected 35 statements for the survey after reviewing scientific literature. Invited participants, selected on the basis of expertise, geographical and gender distribution, were asked to express agreement on the statements. Consensus was defined as a score of ≥6 points (scale 0 to 9) in ≥70% of answers across two scoring rounds.ResultsA-hundred-and-two (72.3%) out of 141 invited experts participated the first round. Their response rate in the second round was 81%. The final consensus definition of “COPD-BE association” was: “The coexistence of (1) specific radiological findings (abnormal bronchial dilatation, airways visible within 1 cm of pleura and/or lack of tapering sign in ≥1 pulmonary segment and in >1 lobe) with (2) an obstructive pattern on spirometry (FEV1/FVC<0.7), (3) at least two characteristic symptoms (cough, expectoration, dyspnoea, fatigue, frequent infections) and (4) current or past exposure to smoke (≥10 pack-years) or other toxic agents (biomass, etc.)”. These criteria form the acronym “ROSE” (Radiology, Obstruction, Symptoms, Exposure).ConclusionsThe Delphi process formulated a European consensus definition of “COPD-BE association”. We hope this definition will have broad applicability across clinical practice and research in the future.

BRONCHIECTASIS IN CHILDHOOD

PEDIATRICS ◽  
1949 ◽  
Vol 4 (1) ◽  
pp. 21-46
Author(s):  
C. ELAINE FIELD
Keyword(s):  
Main Bronchus ◽  
Age At Onset ◽  
Lower Lobe ◽  
Normal Children ◽  
Parental History ◽  
Abnormal Chest ◽  
Characteristic Features ◽  
Chest Deformities ◽  
Bronchial Dilatation ◽  
First Year Of Life

In a study of 160 cases of irreversible bronchiectasis in childhood the following observations have been made: From the history given by the parents, it was found that the age at onset of symptoms lay in the first year of life in approximately one fifth of the cases, the number thereafter declining with advancing age (except for a slight and possibly insignificant rise at age 5). In 55.6% of cases the parental history associated the onset of symptoms with an attack of pneumonia or pertussis. The characteristic features of the disease included a constant cough with or without sputum (this is often swallowed by children). Haemoptysis was rare, but in 33.1% of cases there were associated asthmatic symptoms. More children were underweight than overweight for age and many had abnormal chest deformities. Clubbing occurred in 43.7% and when present was diagnostic of irreversible bronchiectasis in this series. Physical signs in the chest were variable, but the most useful diagnostic finding was localized rales on deep inspiration over the suspected area of lung. In comparison with nonpulmonary and normal children, there was a marked increased incidence of pneumonia at all ages. There was, however, no suggestion that bronchiectasis increased or decreased susceptibility to tuberculosis. Sinusitis is frequently associated with bronchiectasis although its exact relationship remains obscure. In diagnosis, roentgenographic findings are frequently inconclusive, unless confirmed by bronchogram. Bronchography is by far the most important diagnostic procedure and is an invaluable method of studying the development of the disease. Tubular dilatation was the commonest type of bronchiectasis. In 85.6% of cases the disease was situated in the left lower lobe, and in 65.6%, in the lingula lobe, but in no case was the lingula affected as the only lobe. The disease has shown a predilection for lobes whose bronchi are directed upwards against gravity towards the main bronchus and those which have an anatomic peculiarity impeding drainage. Massive collapse of the lung was associated with bronchiectasis in 74 (46.3%) cases. It is important to recognize in children that bronchial dilatation may be reversible. In the diagnosis of irreversibility, duration of the dilatation and its contour are helpful. Bronchoscopy was not helpful in diagnosis or localization of bronchiectasis. The sedimentation rate was frequently raised, but was of little help in assessing activity of the disease. Alterations in the blood count were few and usually only of significance in severe active cases of the disease. Complications were infrequent, the commonest being pneumonia which occurred in 16.3% of cases.

Bronchiectasis

Chest Imaging ◽  
2019 ◽  
pp. 319-323
Author(s):  
Bethany Milliron ◽  
Brent P. Little ◽  
Travis S. Henry
Keyword(s):  
Cystic Fibrosis ◽  
Young Adulthood ◽  
Chronic Infection ◽  
Pulmonary Function Testing ◽  
Average Life Expectancy ◽  
Single Region ◽  
Bronchial Dilatation ◽  
Function Testing ◽  
Traction Bronchiectasis ◽  
Airway Colonization

Bronchiectasis represents irreversible bronchial dilatation. It can be focal or diffuse, and usually results from chronic infection, proximal airway obstruction, or a congenital bronchial abnormality. Traction bronchiectasis refers to irregular bronchial dilatation in the setting of surrounding pulmonary fibrosis. Patients with cystic fibrosis have a progressively worsening clinical course, with recurrent pneumonias and chronic airway colonization. Even with lung transplantation and modern antibiotic therapies, average life expectancy of cystic fibrosis patients remains limited to young adulthood. Non-cystic fibrosis related bronchiectasis can cause chronic cough and recurrent lung infection. Pulmonary function testing often reveals evidence of obstruction. Treatment of patients with mild to moderate bronchiectasis involves supportive care with bronchodilators, antibiotics, and other medical therapy. Surgical resection is uncommon, and usually reserved for cases of significant bronchiectasis limited to a single region of the lungs (such as a particular lobe or segment).

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