eMedicine Specialties > Radiology > Chest

Bronchiectasis: Follow-up

Author: Isaac Hassan, MB, ChB, FRCR, DMRD, Former Senior Consultant Radiologist, Department of Radiology, St Bernard's Hospital, Gibraltar
Contributor Information and Disclosures

Updated: Mar 4, 2009

Intervention

Bronchial arterial embolization offers an alternative to surgery in select patients with massive or recurrent hemoptysis caused by bronchiectasis, particularly in those patients with cystic fibrosis. In most patients, the hemoptysis originates in the systemic bronchial arteries rather than from the pulmonary arteries.

Selective arteriography of the bronchial arteries is performed to locate the source of the bleeding. In bronchiectasis, bleeding is usually a result of enlarged, dilated bronchial arteries, which are occluded by embolization with use of particulate material larger than the smaller arterioles.

Spinal cord infarction is a potential complication of bronchial artery embolization and arises because the bronchial arteries may communicate with arteries that supply the spinal cord.

Medicolegal Pitfalls

  • Failure to exclude tumor and foreign body obstruction as the cause of bronchiectasis
  • Failure to identify and effectively treat allergic bronchopulmonary aspergillosis, atypical mycobacterial infections, immunodeficiency states, and rheumatic diseases
  • Failure to recognize complications such as recurrent pneumonia, empyema, and lung abscess
 


More on Bronchiectasis

Overview: Bronchiectasis
Imaging: Bronchiectasis
Follow-up: Bronchiectasis
Multimedia: Bronchiectasis
References
Further Reading
[ CLOSE WINDOW ]

References

  1. Redding G, Singleton R, Lewis T, et al. Early radiographic and clinical features associated with bronchiectasis in children. Pediatr Pulmonol. Apr 2004;37(4):297-304.

  2. Redding GJ. Bronchiectasis in Children. Pediatr Clin North Am. Feb 2009;56(1):157-171. [Medline].

  3. Reid LM. Reduction in bronchial subdivision in bronchiectasis. Thorax. Sep 1950;5(3):233-47. [Medline].

  4. King PT, Holdsworth SR, Freezer NJ, et al. Characterisation of the onset and presenting clinical features of adult bronchiectasis. Respir Med. Dec 2006;100(12):2183-9.

  5. Tsao PC, Lin CY. Clinical spectrum of bronchiectasis in children. Acta Paediatr Taiwan. Sep-Oct 2002;43(5):271-5.

  6. Edwards EA, Metcalfe R, Milne DG, et al. Retrospective review of children presenting with non cystic fibrosis bronchiectasis: HRCT features and clinical relationships. Pediatr Pulmonol. Aug 2003;36(2):87-93.

  7. Failo R, Wielopolski PA, Tiddens HA, Hop WC, Pozzi Mucelli R, Lequin MH. Lung morphology assessment using MRI: A robust ultra-short TR/TE 2D steady state free precession sequence used in cystic fibrosis patients. Magn Reson Med. Jan 22 2009;61(2):299-306. [Medline].

  8. Hansell DM. Bronchiectasis. Radiol Clin North Am. Jan 1998;36(1):107-28. [Medline].

  9. Godoy MC, Vos PM, Cooperberg PL, Lydell CP, Phillips P, Müller NL. Chest radiographic and CT manifestations of chronic granulomatous disease in adults. AJR Am J Roentgenol. Nov 2008;191(5):1570-5. [Medline].

  10. Bruzzi JF, Remy-Jardin M, Delhaye D, et al. Multi-detector row CT of hemoptysis. Radiographics. Jan-Feb 2006;26(1):3-22.

  11. Lynch DA, Travis WD, Muller NL, et al. Idiopathic interstitial pneumonias: CT features. Radiology. Jul 2005;236(1):10-21. [Full Text].

  12. Okada F, Ando Y, Honda K, Tanoue S, Matsumoto S, Mori H. Comparison of pulmonary CT findings and serum KL-6 levels in patients with cryptogenic organizing pneumonia. Br J Radiol. Dec 8 2008;[Medline].

  13. Suga K, Yasuhiko K, Iwanaga H, Tokuda O, Matsunaga N. Functional mechanism of lung mosaic CT attenuation: assessment with deep-inspiration breath-hold perfusion SPECT-CT fusion imaging and non-breath-hold Technegas SPECT. Acta Radiol. Jan 2009;50(1):34-41. [Medline].

  14. Desai SR, Wells AU, Cheah FK, et al. The reproducibility of bronchial circumference measurements using computed tomography. Br J Radiol. Mar 1994;67(795):257-62. [Medline].

  15. Fraser RS, Muller NL, Colman NC, Pare PD. Bronchiectasis and other bronchial abnormalities. In: Fraser RS, Muller NL, Colman NC, et al, eds. Fraser and Pare's Diagnosis of Diseases of the Chest. 4th ed. Philadelphia, Pa: WB Saunders;1999: 2265-97.

  16. Grenier PA, Beigelman-Aubry C, Fetita C, et al. New frontiers in CT imaging of airway disease. Eur Radiol. May 2002;12(5):1022-44. [Medline].

  17. Joharjy IA, Bashi SA, Adbullah AK. Value of medium-thickness CT in the diagnosis of bronchiectasis. AJR Am J Roentgenol. Dec 1987;149(6):1133-7. [Medline].

  18. McGuinness G, Naidich DP. CT of airways disease and bronchiectasis. Radiol Clin North Am. Jan 2002;40(1):1-19. [Medline].

  19. Naidich DP. High-resolution computed tomography of cystic lung disease. Semin Roentgenol. Apr 1991;26(2):151-74. [Medline].

  20. Pifferi M, Caramella D, Bulleri A, et al. Pediatric bronchiectasis: correlation of HRCT, ventilation and perfusion scintigraphy, and pulmonary function testing. Pediatr Pulmonol. Oct 2004;38(4):298-303.

  21. Smith IE, Flower CD. Review article: imaging in bronchiectasis. Br J Radiol. Jul 1996;69(823):589-93. [Medline].

  22. Swanson KL, Johnson CM, Prakash UB, et al. Bronchial artery embolization: experience with 54 patients. Chest. Mar 2002;121(3):789-95. [Medline]. [Full Text].

  23. van der Bruggen-Bogaarts BA, van der Bruggen HM, van Waes PF, Lammers JW. Screening for bronchiectasis. A comparative study between chest radiography and high-resolution CT. Chest. Mar 1996;109(3):608-11. [Medline].

  24. Webb WR, Muller NL, Naidich DP. High-Resolution CT of the Lung. 2nd ed. Philadelphia, Pa: Lippincott-Raven;1996.

  25. Westcott JL. Bronchiectasis. Radiol Clin North Am. Sep 1991;29(5):1031-42. [Medline].

[ CLOSE WINDOW ]

Keywords

bronchiectasis, bronchial tree disease, pulmonary disease, abnormal dilatation of bronchi, pulmonary infections, cystic fibrosis, Young syndrome, primary ciliary dyskinesia, allergic bronchopulmonary aspergillosis, hypogammaglobulinemia, bronchopulmonary sequestration, Williams-Campbell syndrome, Mounier-Kuhn syndrome, Swyer-James syndrome, yellow nail syndrome, rheumatoid arthritis, Sjögren syndrome

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Isaac Hassan, MB, ChB, FRCR, DMRD, Former Senior Consultant Radiologist, Department of Radiology, St Bernard's Hospital, Gibraltar
Isaac Hassan, MB, ChB, FRCR, DMRD is a member of the following medical societies: American Roentgen Ray Society and Royal College of Radiologists
Disclosure: Nothing to disclose.

Medical Editor

Judith K Amorosa, MD, FACR, Clinical Professor and Program Director, Department of Radiology, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School; Consulting Staff, Department of Radiology, Robert Wood Johnson University Hospital
Judith K Amorosa, MD, FACR is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Association of University Radiologists, Radiological Society of North America, and Society of Thoracic Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

John D Newell, Jr, MD, FACR, FCCP, FASER, Co-Director of Thoracic Imaging, UCDHSC; Director of Lung Imaging Center, Professor of Radiology and Professor of Medicine, Department of Radiology, University of Colorado Health Sciences Center, National Jewish Medical and Research Center; Univ. Colorado Hospital
John D Newell, Jr, MD, FACR, FCCP, FASER is a member of the following medical societies: American College of Chest Physicians, American College of Radiology, American Roentgen Ray Society, American Thoracic Society, Association of University Radiologists, Radiological Society of North America, and Society of Thoracic Radiology
Disclosure: Siemens Medical Grant/research funds Consulting; Forevision Technologies Ownership interest Consulting; Vida Corporation Ownership interest Board membership; TeraRecon Grant/research funds Consulting; eMedicine Honoraria Consulting

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.