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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 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.
==Causes==
==Causes==
Atelectasis may arise due to 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, 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. The extent of atelectasis depends upon the level of obstruction. Lobar atelectasis may develop due to lobar bronchus obstruction while segmental atelectasis may develop due to obstruction of the segmental bronchus.
* 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.
 
* 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.  
The rate and pattern of development of atelectasis depend on collateral ventilation and gas composition of inspired air.
 
Middle lobe syndrome (Fixed or recurrent atelectasis of the lingula/right middle lobe): 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 ===
Non obstructive atelectasis may occur due to severe lung scarring caused by necrotizing pneumonia or granulomatous diseases (cicatrisation atelectasis) or infiltration (replacement atelectasis), extrinsic lung compression (due to thoracic space occupying lesions), diminished levels of surfactant(adhesive atelectasis presenting as ARDS), and passive atelectasis due to absence of contact between the parietal and visceral pleurae due to fluid (pleural effusion), air (pneumothorax), blood (hemothorax) etc.
* Non obstructive atelectasis may occur due to the following reasons:
 
** Severe lung scarring caused by necrotizing [[pneumonia]] or [[Sarcoidosis|granulomatous diseases]]: Cicatrisation atelectasis
Atelectasis of the upper lobe commonly occurs due to pneumothorax, whereas atelectasis of the middle and lower lobes occurs due to pleural effusion.
** [[Lung]] infiltration: Replacement atelectasis
** Extrinsic lung compression: due to thoracic space occupying lesions
** 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]].


Rounded atelectasis:This is a form of atelectasis that is characterized by the formation of fibrous bands which adhere the lung to the pleura. There is a high association of rounded atelectasis in asbestosis due to the formation of fibrous pleural plaques.
* Formation of fibrous bands which adhere the [[lung]] to the [[Pleural cavity|pleura]] in patients with [[asbestosis]]: Rounded atelectasis
Mean age of presentation is 60 years.


===Common Causes===
===Common Causes===
The most common causes of Atelectasis are:
The most common causes of Atelectasis are:
* [[Anesthesia]]
* [[Anesthesia]]
* Foreign object in the airway
* Foreign bodies
* [[Lung Disease]]
* [[Lung Disease]]
* [[Mucus]] Plug
* [[Mucus]] Plug

Revision as of 14:50, 15 February 2018

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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 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, tubercle). Another cause is poor surfactant spreading during inspiration, causing an increase in surface tension which tends to collapse smaller alveoli.

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

  • Formation of fibrous bands which adhere the lung to the pleura in patients with asbestosis: Rounded atelectasis

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

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