Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can...
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Transcript of Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can...
![Page 1: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/1.jpg)
Atelectasis
![Page 2: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/2.jpg)
What does atelectasis mean?
• Lung collapse with loss of internal air• Atelectasis can affect:
– a subunit of a lobe (subsegmental)– a lobe– or a whole lung
• Subsegmental atelectasis is most common
![Page 3: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/3.jpg)
Causes of Lobar/Whole Lung Atelectasis
• Proximal stenosing bronchogenic carcinoma
• Asthma (mucus plugging)• Inhaled foreign body • Retention of secretions (e.g.
postop)• Endotracheal tube inserted too far
![Page 4: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/4.jpg)
CXR Features of Lobar/Whole Lung
Atelectasis• Ipsilateral tracheal displacement• Increased density of collapsed lung
tissue• Ipsilateral mediastinal shift • Elevation of the hemidiaphragm• Herniation of the opposite lung across
the midline
![Page 5: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/5.jpg)
Complete left lung collapse
![Page 6: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/6.jpg)
Complete left lung collapse
Trachea deviated to left
Heart shifted to left
Opaque (white) hemithorax,
caused by non-aerated lung
![Page 7: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/7.jpg)
Patterns of Lobar Collapse
• The left lung has 2 lobes (upper, lower), and the right lung 3 lobes (upper, middle, and lower)
• The collapse of each lobe has specific appearances on a CXR
• Examples of each type of lobar collapse now follow
• A revision of your lung anatomy now might be helpful
![Page 8: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/8.jpg)
Surface markings of the lobes
•The lingula is part of the left upper lobe•Note that the lower lobes extend quite high – above the level of the carina
![Page 9: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/9.jpg)
Right Upper Lobe Collapse
![Page 10: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/10.jpg)
Examples of Lobar Atelectasis
• There now follows examples of each type of lobar atelectasis.
• Some are difficult to recognise!• For each one, look for volume loss
(e.g. ribs closer together), and movement of other structures to occupy the space created by the atelectasis.
![Page 11: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/11.jpg)
Right Lower Lobe Collapse
![Page 12: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/12.jpg)
Right Lower Lobe Collapse
The right lung has lost volume and the horizontal fissure is depressed (red arrow)
![Page 13: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/13.jpg)
Middle Lobe Collapse
![Page 14: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/14.jpg)
Middle Lobe Collapse
The right heart border is blurred. Middle lobe collapse can be very difficult to detect, and a lateral CXR can be helpful if in
doubt (next slide)
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Middle Lobe Collapse
Note the wedge shape on the lateral CXR. The horizontal fissure (arrow) is depressed
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Left Upper Lobe Collapse
![Page 17: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/17.jpg)
RLeft Upper Lobe Collapse
![Page 18: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/18.jpg)
Note loss of volume of the left hemithorax and generalised increased
density. The lung markings still visible are those of the lower lobe, which expands to fill the
space left by the collapsed upper lobe
R
Left Upper Lobe Collapse
![Page 19: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/19.jpg)
Left Lower Lobe Collapse
![Page 20: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/20.jpg)
Left Lower Lobe Collapse
Note loss of left diaphragm contour medially, volume loss of the left hemithorax and the retrocardiac straight line (representing the collapsed lower lobe)
![Page 21: Atelectasis. What does atelectasis mean? Lung collapse with loss of internal air Atelectasis can affect: –a subunit of a lobe (subsegmental) –a lobe –or.](https://reader030.fdocuments.in/reader030/viewer/2022012402/56649cef5503460f949bd408/html5/thumbnails/21.jpg)
Take Home Points
• The commonest cause of lobar / total lung collapse in adults is lung cancer
• All patients with lobar or total lung collapse need further assessment to determine the underlying cause
• The CXR appearances of collapse vary according to where the collapse is