Discoid Atelectasis

by Shaun Damon

The definition of atelectasis is the collapse of part or the whole of the lungs. The collapsed part is then devoid of any airflow and does not re-inflate properly. Atelectasis is a common side effect of surgery and anesthesia use. It also develops in patients who have been in hospital for a long time or have been confined to bed rest for a while. There are many different types of atelectasis depending on the cause of the condition and the severity of the symptoms. Discoid atelectasis is one such type of atelectasis. Discoid atelectasis refers to a small area or small segment of the lungs that is affected by the condition. In a chest x-ray, discoid atelectasis will show up as a disc or plate-like shadow on the lungs. This disc may be linear or horizontal in position. Discoid or Plate atelectasis is diagnosed and treated in much the same way as other types of atelectasis.

The most common causes of discoid atelectasis include:    

  • Shallow breathing (hypoventilation) that occurs post abdominal or chest surgery
  • As a side effect of general anesthesia
  • Pulmonary embolism
  • Ascites or swelling of the abdomen
  • Diaphragmatic paralysis
Other possible causes of discoid atelectasis include:

  • Obstruction of the airways by a foreign object
  • Lung diseases
  • Mucus plugs that block the bronchioles in the lungs
  • Pleural effusion that increases the pressure on the lungs
  • Tumors
Symptoms of discoid atelectasis as with most other types of atelectasis are often confused for other illnesses. Symptoms such as breathing difficulties, chest pain and cough are general enough to make a diagnosis of the disease problematic. Only with a chest x-ray or a chest CT scan will a doctor be able to confirm his diagnosis of atelectasis. When the area of collapse is small, often there may be no symptoms or signs and the condition may simply resolve itself over time. In severe cases however, symptoms can affect a person’s breathing and may be life-threatening if not treated in time.

Treatment for Discoid Atelectasis

The ultimate goal of any type of treatment for atelectasis is to re-inflate the collapsed portion of the lungs and get the breathing back to normal. Depending on the cause of the condition, treatment will vary. Methods may include:

  • Postural drainage where the person is tilted forward with his head below the heart levels to encourage drainage of excess fluid collected in the lungs
  • Clapping the chest to loosen mucus plugs or blockages
  • Deep breathing exercises to encourage proper breathing post surgery or hospitalization
  • Removal of blockages through a procedure known as bronchoscopy
  • Shifting the patient often in cases of bed rest and confinement. This prevents the collapse of the lung and allows the deflated part to re-inflate as well
  • Use of devices known as Positive and Expiratory Pressure (PEP) devices to improve air pressure in the airways
In most cases where the area of collapse is small, discoid atelectasis is not a cause for concern. In time and with the proper treatment the area of the collapsed lung will re-inflate and function normally. During the period of recovery, the rest of the lungs can usually make up for the oxygen deficit produced by the collapsed area. In cases where the collapse is complete or large, the situation requires immediate medical attention. Children or infants with atelectasis or those who suffer from other respiratory conditions along with atelectasis may require hospitalization or surgery to treat the condition. People with atelectasis are also more vulnerable to pneumonia so extra care has to be taken to prevent any infections during the recovery phase. Severe cases of discoid atelectasis may cause damage and scarring to the lungs in the long-term as well.

References:
  1. http://www.nhlbi.nih.gov/health/health-topics/topics/atl/

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