Atelectasis causes: Difference between revisions

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Revision as of 15:05, 15 February 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Somal Khan, M.D., Jacquelyne DiTroia

Overview

The most common cause of atelectasis is postoperative atelectasis, due to the effect of surgical manipulation or general anaesthesia on the patient. Obstructive atelectasis mostly develops due to blockage within the bronchiole or bronchus, which may be within the airway (foreign bodies, mucus plugs), arising from the wall (tumors such as squamous cell carcinoma) or space occupying lesions within the thoracic cavity (tumor, lymph node, tubercle). Causes of non obstructive atelectasis include impaired surfactant formation or activation, leading to alveolar collapse due to increased surface tension.

Causes

Atelectasis may arise due to obstructive and non-obstructive causes.

Obstructive atelectasis

Obstructive atelectasis, which is the most common type of atelectasis may develop due to obstruction by foreign bodies, tumors and mucus plugs. In case of obstruction from the trachea to the alveoli at any level, alveolar gas reabsorption may occur leading to subsequent atelectasis.
Middle lobe syndrome (fixed or recurrent atelectasis of the lingula/ right middle lobe) may occur due to Sjogren’s syndrome. Intraluminal or extraluminal obstruction (compression of the bronchi by adjacent structures) may result in middle lobe syndrome.

Non-obstructive atelectasis

Non obstructive atelectasis may occur due to the following reasons:
- Severe lung scarring caused by necrotizing pneumonia or granulomatous diseases: Cicatrisation atelectasis
- Lung infiltration: Replacement atelectasis
- Extrinsic lung compression: due to thoracic space occupying lesions
- Diminished levels of surfactant: Adhesive atelectasis presenting as ARDS
- Absence of contact between the parietal and visceral pleurae due to fluid (pleural effusion), air (pneumothorax), blood (hemothorax): Passive atelectasis
- Formation of fibrous bands which adhere the lung to the pleura in patients with asbestosis: Rounded atelectasis
- Complication of surgery or anaesthesia leading to decreased surfactant activity and dysfunction of the diaphragm: Postoperative atelectasis

Common Causes

The most common causes of Atelectasis are:

Anesthesia
Foreign bodies
Lung Disease: Pulmonary embolism, lower respiratory tract infections
Mucus Plug
Pleural Effusion
Tumors
Blood clot
Chest Trauma
Pneumonia
Pneumothorax
Scarring of lung parenchyma
Acetaminophen
Follitropin beta
Urofollitropin

Causes by Organ System

Cardiovascular	No underlying causes
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Anesthesia, Acetaminophen, Follitropin beta, Urofollitropin
Ear Nose Throat	Mucus Plug
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	Blood clot
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal / Ortho	No underlying causes
Neurologic	No underlying causes
Nutritional / Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	Tumors
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	Lung Disease, Pleural Effusion, Pneumonia, Pneumothorax, Scarring of Lung Tissue
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	No underlying causes
Sexual	No underlying causes
Trauma	Chest Trauma
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Foreign object in the airway

Causes in Alphabetical Order

Acetaminophen
Anesthesia
Blood clot
Chest Trauma
Follitropin beta
Foreign object in the airway
Lung Disease
Mucus Plug
Pleural Effusion
Pneumonia
Pneumothorax
Scarring of Lung Tissue
Tumors
Urofollitropin

References

Template:WH Template:WS

@@ Line 5: / Line 5: @@
 ==Overview==
-The most common cause is post-surgical atelectasis, characterized by splinting, restricted breathing after abdominal surgery.  Outside of this context, atelectasis implies some blockage of a [[bronchiole]] or [[bronchus]], which can be within the airway (foreign body, mucus plug), from the wall (tumor, usually [[squamous cell carcinoma]]) or compressing from the outside ([[tumor]], [[lymph node]], [[Tuberculosis|tubercle]]).  Another cause is poor [[pulmonary surfactant|surfactant]] spreading during [[Inhalation|inspiration]], causing an increase in [[surface tension]] which tends to collapse smaller alveoli.
+The most common cause of atelectasis is postoperative atelectasis, due to the effect of surgical manipulation or [[general anaesthesia]] on the patient. Obstructive atelectasis mostly develops due to blockage within the [[bronchiole]] or [[bronchus]], which may be within the airway (foreign bodies, mucus plugs), arising from the wall (tumors such as [[squamous cell carcinoma]]) or space occupying lesions within the thoracic cavity ([[tumor]], [[lymph node]], [[Tuberculosis|tubercle]]). Causes of non obstructive atelectasis include impaired [[pulmonary surfactant|surfactant]] formation or activation, leading to alveolar collapse due to increased surface tension.
 ==Causes==
 [[Atelectasis]] may arise due to [[Obstruction|obstructive]] and non-obstructive causes.
@@ Line 20: / Line 20: @@
 ** Diminished levels of [[Pulmonary surfactant|surfactant]]: Adhesive atelectasis presenting as [[Acute respiratory distress syndrome|ARDS]]
 ** Absence of contact between the [[Parietal pleura|parietal]] and [[Visceral pleura|visceral pleurae]] due to fluid ([[pleural effusion]]), air ([[pneumothorax]]), blood ([[hemothorax]]): Passive atelectasis
-* Atelectasis of the upper lobe commonly occurs due to [[pneumothorax]], whereas atelectasis of the middle and lower lobes occurs due to [[pleural effusion]].
+** Formation of fibrous bands which adhere the [[lung]] to the [[Pleural cavity|pleura]] in patients with [[asbestosis]]: Rounded atelectasis
+** Complication of [[surgery]] or [[Anesthesia|anaesthesia]] leading to decreased surfactant activity and dysfunction of the [[Thoracic diaphragm|diaphragm]]: Postoperative atelectasis
-* Formation of fibrous bands which adhere the [[lung]] to the [[Pleural cavity|pleura]] in patients with [[asbestosis]]: Rounded atelectasis
 ===Common Causes===
@@ Line 28: / Line 27: @@
 * [[Anesthesia]]
 * Foreign bodies
-* [[Lung Disease]]
+* [[Lung Disease]]: [[Pulmonary embolism]], [[Lower respiratory tract infection|lower respiratory tract infections]]
 * [[Mucus]] Plug
 * [[Pleural Effusion]]
@@ Line 36: / Line 35: @@
 * [[Pneumonia]]
 * [[Pneumothorax]]
-* Scarring of Lung Tissue
+* Scarring of lung parenchyma
 * [[Acetaminophen]]
 * [[Follitropin beta]]