Which chest exam finding may be present in bronchiectasis?

• A. Dull percussion
• B. Increased tactile fremitus with dullness
• C. Hyperresonant percussion with tympanic note
• D. Normal examination

Answer: (C)

Bronchiectasis often leads to air trapping and overinflation of the lungs because of chronic mucus plugging and obstructed airways. This air trapping makes the lungs more resonant to percussion, producing a hyperresonant sound, and in some cases a tympanitic (more hollow, drum-like) quality due to the excess air in the chest. This pattern is more consistent with the obstructive, hyperinflated state seen in bronchiectasis than with consolidation or pleural effusion, which would tend to produce dullness and increased tactile fremitus instead. Normal exam can occur, but when bronchiectasis has progressed with mucus plugging and obstruction, hyperresonant or tympanitic percussion fits better.