Atelectasis causes: Difference between revisions

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{{Atelectasis}}
{{Atelectasis}}


{{CMG}}; {{AE}} Somal Khan, M.D., Jacquelyne DiTroia
{{CMG}}; {{AE}} {{Cherry}}


==Overview==
==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]], [[Tuberculosis|tubercle]]). Causes of non obstructive atelectasis include impaired [[pulmonary surfactant|surfactant]] formation or activation, leading to alveolar collapse due to increased surface tension.
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==
==Causes==
[[Atelectasis]] may arise due to [[Obstruction|obstructive]] and non-obstructive causes.  
[[Atelectasis]] may arise due to [[Obstruction|obstructive]] and non-obstructive causes.  


=== Obstructive atelectasis ===
=== Obstructive atelectasis ===
* Obstructive atelectasis, which is the most common type of atelectasis may develop due to [[obstruction]] by [[foreign bodies]], [[Tumor|tumors]] and mucus plugs. In case of obstruction from the [[Tracheal bronchus|trachea]] to the [[Pulmonary alveolus|alveoli]] at any level, [[Alveolus|alveolar]] gas reabsorption may occur leading to subsequent atelectasis. 
Common causes of obstructive atelectasis include obstruction by:<ref name="urlAtelectasis - Symptoms and causes - Mayo Clinic">{{cite web |url=https://www.mayoclinic.org/diseases-conditions/atelectasis/symptoms-causes/syc-20369684 |title=Atelectasis - Symptoms and causes - Mayo Clinic |format= |work= |accessdate=}}</ref>
* Middle lobe syndrome (fixed or recurrent atelectasis of the [[lingula]]/ right middle lobe) may occur due to [[Sjögren's syndrome|Sjogren’s syndrome]]. Intraluminal or extraluminal [[obstruction]] (compression of the [[Bronchus|bronchi]] by adjacent structures) may result in middle lobe syndrome.  
* Foreign bodies
* Tumors
* Mucus plugs
* Middle lobe syndrome<ref name="pmid16548837">{{cite journal |vauthors=Chen HA, Lai SL, Kwang WK, Liu JC, Chen CH, Huang DF |title=Middle lobe syndrome as the pulmonary manifestation of primary Sjögren's syndrome |journal=Med. J. Aust. |volume=184 |issue=6 |pages=294–5 |year=2006 |pmid=16548837 |doi= |url=}}</ref><ref name="pmid6611925">{{cite journal |vauthors=Rosenbloom SA, Ravin CE, Putman CE, Sealy WC, Vock P, Clark TJ, Godwin JD, Chen JT, Baber C |title=Peripheral middle lobe syndrome |journal=Radiology |volume=149 |issue=1 |pages=17–21 |year=1983 |pmid=6611925 |doi=10.1148/radiology.149.1.6611925 |url=}}</ref>


=== Non-obstructive atelectasis ===
=== Non-obstructive atelectasis ===
* Non obstructive atelectasis may occur due to the following reasons:
* Non obstructive atelectasis may occur due to the following reasons:<ref name="urlAtelectasis - Symptoms and causes - Mayo Clinic">{{cite web |url=https://www.mayoclinic.org/diseases-conditions/atelectasis/symptoms-causes/syc-20369684 |title=Atelectasis - Symptoms and causes - Mayo Clinic |format= |work= |accessdate=}}</ref><ref name="urlAtelectasis | Causes, Symptoms, Treatment & Prevention">{{cite web |url=http://www.innerbody.com/diseases-conditions/atelectasis |title=Atelectasis &#124; Causes, Symptoms, Treatment & Prevention |format= |work= |accessdate=}}</ref>
** Severe lung scarring caused by necrotizing [[pneumonia]] or [[Sarcoidosis|granulomatous diseases]]: Cicatrisation atelectasis
{| class="wikitable"
** [[Lung]] infiltration: Replacement atelectasis
!Type of non-obstructive atelectasis
** Extrinsic lung compression: due to thoracic space occupying lesions
!Pathophysiology behind  atelectasis
** 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  
|Cicatrisation atelectasis
** Formation of fibrous bands which adhere the [[lung]] to the [[Pleural cavity|pleura]] in patients with [[asbestosis]]: Rounded atelectasis
|Severe lung scarring caused by necrotizing [[pneumonia]] or [[Sarcoidosis|granulomatous diseases]]
** Complication of [[surgery]] or [[Anesthesia|anaesthesia]] leading to decreased surfactant activity and dysfunction of the [[Thoracic diaphragm|diaphragm]]: Postoperative atelectasis
|-
|Replacement atelectasis
|[[Lung]] infiltration
|-
|Adhesive atelectasis
|Diminished levels of [[Pulmonary surfactant|surfactant]]  
Presents as [[Acute respiratory distress syndrome|ARDS]]
|-
|Passive atelectasis
|Absence of contact between the [[Parietal pleura|parietal]] and [[Visceral pleura|visceral pleurae]] due to  
* Fluid ([[pleural effusion]])
 
* Air ([[pneumothorax]])
 
* Blood ([[hemothorax]])
|-
|Rounded atelectasis
|Formation of fibrous bands which adhere the [[lung]] to the [[Pleural cavity|pleura]] in patients with [[asbestosis]]
|-
|Postoperative atelectasis
|Complication of [[surgery]] or [[Anesthesia|anaesthesia]] leading to decreased surfactant activity and dysfunction of the [[Thoracic diaphragm|diaphragm]]
|}


===Common Causes===
===Common Causes===
The most common causes of Atelectasis are:
The most common causes of atelectasis are:
* [[Anesthesia]]
* [[Anesthesia]]
* Foreign bodies
* Foreign bodies
* [[Lung Disease]]: [[Pulmonary embolism]], [[Lower respiratory tract infection|lower respiratory tract infections]]
* [[Lung Disease]]: [[Pulmonary embolism]], [[Lower respiratory tract infection|lower respiratory tract infections]]
* [[Mucus]] Plug
* [[Mucus]] plug
* [[Pleural Effusion]]
* [[Pleural Effusion]]
* [[Tumors]]
* [[Tumors]]
* [[Blood clot]]
* [[Blood clot]]
* Chest Trauma
* Chest trauma
* [[Pneumonia]]
* [[Pneumonia]]
* [[Pneumothorax]]
* [[Pneumothorax]]
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|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
| bgcolor="Beige" | [[Lung Disease]], [[Pleural Effusion]], [[Pneumonia]], [[Pneumothorax]], Scarring of Lung Tissue
| bgcolor="Beige" | [[Lung Disease]], [[Pleural effusion]], [[Pneumonia]], [[Pneumothorax]], Scarring of lung tissue
|-
|-
|- bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
Line 162: Line 186:
* [[Anesthesia]]
* [[Anesthesia]]
* [[Blood clot]]
* [[Blood clot]]
* Chest Trauma
* Chest trauma
* [[Follitropin beta]]
* [[Follitropin beta]]
* Foreign object in the airway
* Foreign object in the airway
* [[Lung Disease]]
* [[Lung disease]]
* [[Mucus]] Plug
* [[Mucus]] plug
* [[Pleural Effusion]]
* [[Pleural effusion]]
* [[Pneumonia]]
* [[Pneumonia]]
* [[Pneumothorax]]
* [[Pneumothorax]]
* Scarring of Lung Tissue
* Scarring of lung tissue
* [[Tumors]]
* [[Tumors]]
* [[Urofollitropin]]
* [[Urofollitropin]]

Latest revision as of 15:03, 21 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]

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

Common causes of obstructive atelectasis include obstruction by:[1]

  • Foreign bodies
  • Tumors
  • Mucus plugs
  • Middle lobe syndrome[2][3]

Non-obstructive atelectasis

  • Non obstructive atelectasis may occur due to the following reasons:[1][4]
Type of non-obstructive atelectasis Pathophysiology behind atelectasis
Cicatrisation atelectasis Severe lung scarring caused by necrotizing pneumonia or granulomatous diseases
Replacement atelectasis Lung infiltration
Adhesive atelectasis Diminished levels of surfactant

Presents as ARDS

Passive atelectasis Absence of contact between the parietal and visceral pleurae due to
Rounded atelectasis Formation of fibrous bands which adhere the lung to the pleura in patients with asbestosis
Postoperative atelectasis Complication of surgery or anaesthesia leading to decreased surfactant activity and dysfunction of the diaphragm

Common Causes

The most common causes of atelectasis are:

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

References

  1. ↑ 1.0 1.1 "Atelectasis - Symptoms and causes - Mayo Clinic".
  2. ↑ Chen HA, Lai SL, Kwang WK, Liu JC, Chen CH, Huang DF (2006). "Middle lobe syndrome as the pulmonary manifestation of primary Sjögren's syndrome". Med. J. Aust. 184 (6): 294–5. PMID 16548837.
  3. ↑ Rosenbloom SA, Ravin CE, Putman CE, Sealy WC, Vock P, Clark TJ, Godwin JD, Chen JT, Baber C (1983). "Peripheral middle lobe syndrome". Radiology. 149 (1): 17–21. doi:10.1148/radiology.149.1.6611925. PMID 6611925.
  4. ↑ "Atelectasis | Causes, Symptoms, Treatment & Prevention".

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