Atelectasis causes: Difference between revisions

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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==
Obstructive atelectasis:
Atelectasis may arise due to obstructive and non-obstructive causes.
Most common type of atelectasis
 
In case of obstruction from the trachea to the alveoli at any level, alveolar gas reabsorption may occur leading to diminished lung volume and subsequent atelectasis.
=== Obstructive atelectasis ===
The extent of atelectasis depends upon the level of obstruction:
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.
Lobar atelectasis: due to lobar bronchus obstruction
Segmental atelectasis: leads to segmental bronchus obstruction


Causes of obstructive atelectasis:
Foreign body
Tumor
Mucus plugs
The rate and pattern of development of atelectasis depend on collateral ventilation and gas composition of inspired air.
The rate and pattern of development of atelectasis depend on collateral ventilation and gas composition of inspired air.
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.


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.
Mean age of presentation is 60 years.
Middle lobe syndrome (Fixed or recurrent atelectasis of the lingula/right middle lobe): due to Sjogren’s syndrome
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.
Intraluminal or extraluminal obstruction (compression of the bronchi by adjacent structures) may result in middle lobe syndrome.


Non-obstructive causes may also lead to atelectasis of the middle lobe.
=== 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.
 
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.
Mean age of presentation is 60 years.


===Common Causes===
===Common Causes===
Line 49: Line 43:


===Causes by Organ System===
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
{| style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
| style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"|[[Anesthesia]], [[Acetaminophen]], [[Follitropin beta]], [[Urofollitropin]]
| bgcolor="Beige" |[[Anesthesia]], [[Acetaminophen]], [[Follitropin beta]], [[Urofollitropin]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"| [[Mucus]] Plug
| bgcolor="Beige" | [[Mucus]] Plug
|-  
|-  
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-  
|-  
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| [[Blood clot]]
| bgcolor="Beige" | [[Blood clot]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| [[Tumors]]
| bgcolor="Beige" | [[Tumors]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Opthalmologic'''
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
| '''Overdose / Toxicity'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-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"
| '''Renal / Electrolyte'''
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| Chest Trauma
| bgcolor="Beige" | Chest Trauma
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dental'''
| '''Dental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| Foreign object in the airway
| bgcolor="Beige" | Foreign object in the airway
|-
|-
|}
|}

Revision as of 21:54, 14 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. 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.

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 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.

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. Mean age of presentation is 60 years.

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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