atelectasis
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Introduction
Collapse of a lung or lung segment occurs secondary to resorption of air behind an obstructed bronchus.
Etiology
- aspirated foreign body
- inspissated mucus
- generally postoperative
- mechanical ventilation[1]
- endobronchial tumor, usually bronchogenic carcinoma
- compression of the bronchus by enlarged hilar lymph nodes
Clinical manifestations
- inspiratory chest expansion lag on affected side
- decreased fremitus
- dullness or flatness to percussion
- breath sounds may be absent over affected region
Radiology
- trachea & heart may be shifted towards affected side
Management
- correct underlying disorder
- chest physiotherapy
- incentive spirometry[3]
- ambulation (early mobilization after surgery)
- non-invasive positive pressure ventilation
- BiPAP for atelectasis from hypoventilation due chest wall restriction (kyphosis, scoliosis, ankylosing spondylitis)
- PEEP if mechanical ventilation with endotracheal tube
More general terms
References
- ↑ 1.0 1.1 Introduction to Clinical Imaging, Radiology Syllabus, UCSF, 1993
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 1146
- ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 16, 17. American College of Physicians, Philadelphia 2012, 2014