ATELECTASIS

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ATELECTASIS
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Types of atelectasis

• Obstructive
• Intrinsic tumors, mucus plugs, foreign bodies
• Extrinsic lymph node enlargement, mediastinal
  masses
• Passive
• Space-occupying lesion within pleural space i.e.
  PTX, HTX, pleural effusion, pleural tumor
• Adhesive
• Inactive or insufficient surfactant i.e. ARDS
• Cicatrization
• Fibrosis or scarring i.e. chronic TB, fungal
  infections, post-radiation

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Diagnosis

• Chest x-ray
• and history and physical examination

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Normal Lung Lobes
Images obtained from http//rad.usuhs.edu/medpix/r
adpix.html
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Signs of atelectasis

• Increase in lung density
• Displacement of interlobar fissures
• Mediastinal shift
• Displacement of hilum
• Elevation of diaphragm
• Compensatory overinflation
• Approximation of ribs

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Complete atelectasis

• Increase in lung density
• Displacement of interlobar fissures
• Shift of trachea / mediastinum
• Displacement of hilum
• Elevation of diaphragm
• Compensatory overinflation
• Approximation of ribs

Image obtained from http//priory.com/cmol/stent1
.jpg
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RUL atelectasis
ribs approximated
elevated horizontal fissure
Golden S sign
trachea slightly deviated
Images obtained from Basic Radiology (Chen MYM,
Pope TL, Ott DJ) via http//www.accessmedicine.com
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RML atelectasis
narrow triangular opacity superimposed on heart
right heart border obscured
Images obtained from Basic Radiology (Chen MYM,
Pope TL, Ott DJ) via http//www.accessmedicine.com
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RLL atelectasis
increased density over lower vertebra
oblique fissure displaced downward
silhouette sign
Images obtained from http//eradiology.bidmc.harva
rd.edu/Classics/list.aspx
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LUL atelectasis
veil-like increased density over entire left
lung
anterior displacement of major fissure
Luftsichel sign
Juxtaphrenic peak sign
Images obtained from Basic Radiology (Chen MYM,
Pope TL, Ott DJ) via http//www.accessmedicine.com
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LLL atelectasis
flat waist sign
silhouette sign
major fissure displaced posteriorly
triangular opacity behind heart
Increased density over lower vertebra
Images obtained from http//eradiology.bidmc.harva
rd.edu/Classics/list.aspx
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