BRONCHIAL OBSTRUCTION
الدكتور خلدون ذنون- كلية طب نينوى- المرحله الرابعهCommon causes
Brochial adenoma& carcinoma.Enlarged tracheobroncheal lymph nodes e.g TB,malignant.
Foreign body inhalation.
Brochial cast or plugs. mucus or blood clots.
e.g asthma, haemoptysis, debility.
5. Ineffective cough e.g postoperative abdominal surgery.
collection of pus or mucopus.
Rare causes
Aortic aneurysm.
Pericardial effusion.
Fibrous bronchial stricture e.g TB, bronchial surgery/lung transplant
Giant left atrium.
Congenital bronchial atresia.
The most common cause of BO is CA. bronchus, form
90% of lung tumors. It is the main cause of death in malignancy in
UK.
Clinical picture
Depend on site, partial or complete obstruction.
Features of underlying disease.
Complete obstruction causes collapse of a lobe or lung, dyspnea, mediastinal shift, dull percussion, and reduced breath sounds.
Partial obstruction may cause local wheeze, impairs drainage of secretions and may result in pneumonia or lung abscess. Occasionally may cause post-obstructive emphysema.
Recurrent Pneumonia slowly responding to treatment may suggest bronchial cancer.
Stridor may result from obstruction of lower trachea, carina, or main bronchi by tumor or adjacent lymph nodes compression.
Bronchiectasis may occur in chronic bronchial obstruction.
Investigations
Chest x-ray and CT scan: may show pulmonary collapse, signs of infection, and localize tumors.
Bronchoscopy and biopsy helpful in tumors and foreign body.
Management
Treat underlying causeAntibiotics for infection.
Removal of foreign body, mucus &viscid secretion by bronchoscopy.
Surgery for tumors.