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atelectasis
Collapse of a lung or lung segment occurs secondary to resorption of air behind an obstructed bronchus.
Etiology:
1) aspirated foreign body
2) inspissated mucus
a) generally postoperative
b) mechanical ventilation [1]
3) endobronchial tumor, usually bronchogenic carcinoma
4) compression of the bronchus by enlarged hilar lymph nodes
Clinical manifestations:
1) inspiratory chest expansion lag on affected side
2) decreased fremitus
3) dullness or flatness to percussion
4) 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
General
lung disease
sign/symptom
References
- 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
- Medical Knowledge Self Assessment Program (MKSAP) 16, 17.
American College of Physicians, Philadelphia 2012, 2014