THE FATE OF CHILDREN WITH BRONCHIECTASIS

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Abstract
A follow-up study was carried out on 209 children with bronchiec-tiasis. The period of follow-up extends from 2 to 15 years, with an average of 6.4 years in the survivors. In the majority of these children, symptoms began in the early years of life. In nearly all cases the disease began with an acute respiratory infection. The most common initial illness was pneumonia, but infectious diseases, particularly pertussis and measles, are also important. Symptomatology of the disease in childhood is outlined and the importance of febrile attacks in the clinical history is stressed. The association with upper respiratory tract infections, especially sinusitis, is discussed. The radio-logic and bronchographic appearances are described. All cases were bronchoscoped and the findings are given. One hundred-sixty-three cases were treated surgically. Pneumo-nectomy was performed in 48 cases, lobectomy or segmental resection in 112 cases. The late results are described in these cases, many of whom have been followed into adult life. The effect of certain symptoms, notably asthma, on the prognosis of operated cases is discussed. Medical treatment was adopted in 46 cases and a further 15 cases are considered, a total of 61 cases treated conservatively. These cases are considered in three groups: (a) where the condition was too mild for surgery, (b) where the bronchiectasis was too severe for surgery, and (c) where surgical treatment was refused. The late results are described in each group. The place of medical and surgical treatment in childhood bronchiectasis is discussed.

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